The purpose of this study was to evaluate whether antioxidant supplementation with tocopherol, vitamin C, β-carotene, and selenium reduces lipid peroxide levels and increases antioxidative enzyme activities in patients with coronary heart disease.

Eighty nine patients participated in a randomized, double-blind, placebo-controlled trial. The antioxidant group (45 patients) was given daily doses of tocopherol (400 IU), vitamin C (500 mg), β-carotene (15 mg), and selenium (50 microgram) and the placebo group (44) received placebo. Thirty eight of the antioxidant group (84.4%) and thirty nine (88.6%) of the placebo group completed the 3-month supplementation.

Serum levels of α-tocopherol, vitamin C and β-carotene were significantly increased in the antioxidant group as compared to the placebo group (p<0.05), however, retinol was not. Thiobarbituric acid-reactive substances (TBARS) decreased significantly (0.6 nmol MDA/mL) in the antioxidant group as compared with the level (0.09 nmol MDA/mL) seen in the placebo group (p<0.05). Antioxidants did not affect the oxidized-LDL level. The activities of erythrocyte superoxide dismutase (SOD) significantly increased by 0.85 unit/mg hemoglobin in the antioxidant group versus 0.27 unit/mg hemoglobin in the placebo group (p<0.01), and the activities of erythrocyte catalase significantly decreased by 0.04 unit/mg hemoglobin versus 3.37 unit/mg hemoglobin (p<0.01). However, the activities of erythrocyte glutathione peroxidase (GPX) increased insignificantly by 0.09 unit/mg hemoglobin vs 0.1 unit/mg hemoglobin.

These results suggest that antioxidant supplementation with tocopherol, vitamin C, β-carotene and selenium in patients with coronary heart disease may provide a prophylactic effect against oxidative stress.