BACKGROUND: Vitamin E is a widely available drug widely marketed for alleged cardiovascular benefits. However, recent randomized trials do not show consistent risk reductions in cardiovascular outcomes. A meta-analysis conducted three years ago concluded no benefit in high-risk patients, and that further research on it be abandoned. We felt the need to update this study since there continue to be studies with conflicting findings.OBJECTIVE: This meta-analysis aims to update the investigation on whether vitamin E in high-risk patients causes significant risk reductions in non-fatal myocardial infarction, stroke, cardiovascular death, and all-cause mortality.METHODS: A computerized search of Medline was done using the online PubMed system. Randomized, controlled trials involving high-risk patients including a vitamin E treatment arm and a non-supplemental arm that tested for the specified cardiovascular outcomes were reviewed and appraised independently by three investigators. After quality appraisal and validity assessment, data from the Vitamin E treatment arm and placebo/non-supplementation arm were extrapolated from each study and entered into RevMan 4.2.3. Odds ratios were determined and plotted using a random effects model.RESULTS: Eight randomized controlled trials were included in the study. There were no significant reductions in all-cause mortality (OR=1.02, 95 percent CI 0.98-1.07), cardiovascular death (OR=1.00, 95 percent CI 0.95-1.06) or stroke events (OR=0.97, 95 percent CI 0.89-1.07), or. non-fatal myocardial infarction (OR 0.93, 95 percent CI 0.83-1.04).; Moreover, for non-fatal MI outcomes, statistical heterogeneity was present (Chi2 13.46, p = 0.004, I2 77.7 percent).CONCLUSION: We found no significant reduction in risk for cardiovascular outcomes with Vitamin E supplementation in high-risk patients. We conclude that Vitamin E should not be routinely recommended for high-risk patients.
Vitamin E ; Tocopherol ; Alpha Tocopherol ; Antioxidants ; Stroke ; Myocardial Infarction