[Plasma levels of vitamins A and E and the risk of acute myocardial infarct].

Introduction And Objective: The incidence of myocardial infarction in Spain is low in spite of the high prevalence of smoking and hypertension. Natural antioxidants as vitamin E from a diet rich in fruit, oils and vegetables may protect against the development of this disease. In this study we have examine plasma levels of vitamin A and E as risk factors in the development of myocardial infarction.

Study Design: 62 cases were selected among patients 30-70 years old admitted to the hospital with a first episode of myocardial infarction, or diagnosed by arteriography of coronary heart disease. 62 controls were selected among patients with minor surgical conditions, and free of coronary heart disease according to the Rose questionnaire and ECG.

Laboratory Analysis: Plasma samples for vitamin assays were taken in the first 24 hours after admission (62 cases) Plasma was separated by centrifugation and stored at -80 degrees C until plasma vitamins were determined by HPLC.

Results: Lipid adjusted blood levels of vitamin E were lower in cases, mean: 1092.0 +/- standard deviation 165.8 micrograms/dl (mean +/- SD) than in controls (1220.1 +/- 274.8 micrograms/dl p = 0.002). The multivariate adjusted odds ratio between extreme quintiles of blood vitamin E were 0.06 (95% confidence intervals (CI): 0.01-0.5; p for trend 0.0027. Adjusted blood levels of vitamins A were also lower in cases 44.0 +/- 15.1 micrograms/dl than in controls: (57.5 +/- 15.2 micrograms/dl; p < 0.001). Adjusted odds ratio between extreme quintiles of blood vitamin A adjusted for confounding factors were 0.06 (95% CI: 0.01-0.36; p for trend < 0.00001).

Conclusions: There is an association between acute of myocardial infarction and reduce blood levels of vitamin A and E, that is not explained by the decrement in blood lipids levels. Therefore low blood levels of fat soluble vitamins may be a risk factor for the development of this disease.