Background: Excess cardiovascular mortality has been documented in chronic haemodialysis patients. Oxidative stress is greater in haemodialysis patients with prevalent cardiovascular disease than in those without, suggesting a role for oxidative stress in excess cardiovascular disease in haemodialysis. We investigated the effect of high-dose vitamin E supplementation on cardiovascular disease outcomes in haemodialysis patients with pre-existing cardiovascular disease. Methods: Haemodialysis patients with pre-existing cardiovascular disease (n=196) aged 40-75 years at baseline from six dialysis centres were enrolled and randomised to receive 800 IU/day vitamin E or matching placebo. Patients were followed for a median 519 days. The primary endpoint was a composite variable consisting of: myocardial infarction (fatal and non-fatal), ischaemic stroke, peripheral vascular disease (excluding the arteriovenous fistula), and unstable angina. Secondary outcomes included each of the component outcomes, total mortality, and cardiovascular-disease mortality. Findings: A total of 15 (16%) of the 97 patients assigned to vitamin E and 33 (33%) of the 99 patients assigned to placebo had a primary endpoint (relative risk 0.46 [95% CI 0.27-0.78], p=0.014). Five (5.1%) patients assigned to vitamin E and 17 (17.2%) patients assigned to placebo had myocardial infarction (0.3 [0.11-0.78], p=0.016). No significant differences in other secondary endpoints, cardiovascular disease, or total mortality were detected. Interpretation: In haemodialysis patients with prevalent cardiovascular disease, supplementation with 800 IU/day vitamin E reduces composite cardiovascular disease endpoints and myocardial infarction.
|Number of pages||6|
|State||Published - 7 Oct 2000|
Bibliographical noteFunding Information:
We thank the following individuals for their helpful assistance with this study: Alexander Biro, Ze'ev Katzir, Bernardo Hochman, Irena Bakshi, Don Silverberg, Doron Schwartz, Marina Anashkin, Dora Nuzik, Jaques Bernheim, Shimon Weitzman, Emi Kalo, Larissa Shtendick, Shoshana Schwartz, Chaim Brickman, Avigdor Mandelberg, and Elana Broda. This research was funded by grant 4204 from the Chief Scientist's Office, Ministry of Health, Israel.
ASJC Scopus subject areas
- Medicine (all)