Does Vitamin E reduce the Number of Coronary Ischemic Episodes and Should We Use It inPractice
Appraiser: Eric W. Terman
Clinical Bottom Lines:
Date Appraised: July 18, 1997
Vitamin E >400 iu per day did significantly reduce the combined number of non-fatal MI's and cardiovascular death The actual reduction in risk was roughly 2.6%. The treatment was carried out for 510days (1.4 years). This means that 38 patients would need to be treated for 510d before one event was prevented
The study showed a greater reduction for non-fatal MI's, than for fatal cardiovascular events. If only nonfatal events are considered the risk reduction is 2.8% which means 35 would need to be treated.
Double blind placebo RCT of 2002 patients with known CAD
|Outcomes 510 days||Placebo||Vitamin E||Odds Ratio Substitute
Relative Risk Reduction (RRR)
|Major CV events||62/967
|fatal CV events||23/967
|no reduction, also not significant||no benefit|
1. The patient population all had known CAD so this can not be extrapolated to the general
2. There was not a significant reduction in fatal events when comparing Vitamin E to placebo.
3. The Kaplan-Meier curves deviated for both major cardiovascular events and non-fatal MI.
4. There is little harm so if a patient is interested it could be helpful.
Stephens NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study (CHAOS). Lancet. 1996 March 23;347:781-6