α-Tocopherol Supplementation for Men with Existing Coronary Artery Disease: A Feasibility Study, ,

Background. Recent studies have suggested that α-tocopherol supplementation can help reduce the incidence of coronary disease. Our objectives were to determine the feasibility of providing α-tocopherol supplements to male veterans with existing coronary artery disease and determine its effects on α-tocopherol levels and the susceptibility of low-density lipoprotein (LDL) to oxidation. Methods. Fifty-seven percent of 138 coronary disease patients were willing to participate in a placebo-controlled trial −25% were already taking antioxidants. Thirty-nine men were randomly assigned to either 400 mg/day of α-tocopherol (n = 27) or placebo (n = 12). α-Tocopherol levels and LDL oxidation (measured by formation of thiobarbituric acid-reactive substance) were measured at baseline and at 6 months. Results. Thirty-three subjects (22 α-tocopherol, 11 placebo) completed the study; 3 subjects withdrew after suffering coronary disease events. Supplement compliance exceeded 90% and α-tocopherol was well tolerated. The α-tocopherol group had a significantly greater mean increase in lipid-adjusted α-tocopherol levels (73% vs. −4.6%, P < 0.0001), but oxidized LDL did not change significantly. Conclusions. A secondary prevention trial among veterans would be feasible because the rates of enrollment, completion, compliance, and clinical events were high. α-Tocopherol supplements did not decrease the susceptibility of LDL to oxidation, suggesting that higher dosages or longer duration of supplementation may be required for secondary prevention.