抗氧化剂对于妇女二级心血管预防收效甚微

Title: A Randomized Factorial Trial of Vitamins C and E and Beta Carotene in the Secondary Prevention of Cardiovascular Events in Women
Results From the Women's Antioxidant Cardiovascular Study
题目：一项关于维生素C，E,  胡萝卜素在女性二级心血管事件预防的随机化析因试验
结果来自于女性抗氧化剂心血管研究
Author: Nancy R. Cook, ScD; Christine M. Albert, MD; J. Michael Gaziano, MD;et al
作者：Nancy R. Cook, ScD; Christine M. Albert, MD; J. Michael Gaziano, MD;et al
Resource:Arch Intern Med. 2007;167:1610-1618.
选自 Arch Intern Med. 2007;167:1610-1618.
Background Randomized trials have largely failed to support an effect of antioxidant vitamins on the risk of cardiovascular disease (CVD). Few trials have examined interactions among antioxidants, and, to our knowledge, no previous trial has examined the individual effect of ascorbic acid (vitamin C) on CVD.
背景：随机试验很大程度上并不支持抗氧化剂 维生素预防心血管疾病的效果。很少有试验检测抗氧化剂间的相互作用，就我们认为，没有前瞻性研究检测在心血管疾病中维生素C的 个体效应。
Methods The Women's Antioxidant Cardiovascular Study tested the effects of ascorbic acid (500 mg/d), vitamin E (600 IU every other day), and beta carotene (50 mg every other day) on the combined outcome of myocardial infarction, stroke, coronary revascularization, or CVD death among 8171 female health professionals at increased risk in a 2 x 2 x 2 factorial design. Participants were 40 years or older with a history of CVD or 3 or more CVD risk factors and were followed up for a mean duration of 9.4 years, from 1995-1996 to 2005.
方法：女性抗氧化剂心血管研究检测了维生素C （500mg/d）,维生素E（600IU/隔天）， 胡萝卜素（50mg/隔天）的效应，在8171女性健康专职人员高风险人群进行2 x 2 x 2析因设计综合判断心梗，休克，冠状动脉再通，心血管相关死亡的结局。
Results A total of 1450 women experienced 1 or more CVD outcomes. There was no overall effect of ascorbic acid (relative risk [RR], 1.02; 95% CI, 0.92-1.13 [P = .71]), vitamin E (RR, 0.94; 95% CI, 0.85-1.04 [P = .23]), or beta carotene (RR, 1.02; 95% CI, 0.92-1.13 [P = .71]) on the primary combined end point or on the individual secondary outcomes of myocardial infarction, stroke, coronary revascularization, or CVD death. A marginally significant reduction in the primary outcome with active vitamin E was observed among the prespecified subgroup of women with prior CVD (RR, 0.89; 95% CI, 0.79-1.00 [P = .04]; P value for interaction, .07). There were no significant interactions between agents for the primary end point, but those randomized to both active ascorbic acid and vitamin E experienced fewer strokes (P value for interaction, .03).
结果： 总共1450女性经历了1个或更多的 心血管事件结局。维生素C（相对风险[RR], 1.02; 95% CI, 0.92-1.13[P = .71]), 维生素E (RR, 0.94; 95% CI, 0.85-1.04 [P = .23]), 或 胡萝卜素(RR, 1.02; 95% CI, 0.92-1.13 [P = .71])在主要复合终点或个人二级结果如心肌梗死，休克，冠状动脉再通，心血管相关死亡中均没有全面效应。对于前有心血管疾病的女性亚组分析，使用维生素E，可以降低主要结局的发生（RR, 0.89; 95% CI, 0.79-1.00 [P = .04];）。在主要终点中，该剂没有明显的相互作用，但是在随机中发现活性维生素C和维生素E可以减少中风的发生(相互间P=, .03)
Conclusion There were no overall effects of ascorbic acid, vitamin E, or beta carotene on cardiovascular events among women at high risk for CVD.
结论：维生素C，维生素E， 胡萝卜素在女性心血管疾病高危群中预防心血管事件没有全面效应。