Aktuelle Ernährungsmedizin 2011; 36 - P4_9
DOI: 10.1055/s-0031-1276788

Oxidative stress during coronary artery by-pass grafting – a vitamin cocktail attenuates ischemia-reperfusion induced oxidative stress – a pilot investigation

O Stanger 1, I Aigner 1, W Schimetta 2, W Wonisch 3, 4
  • 1Department of Cardiac Surgery, Research, Amino Acid Metabolism, Paracelsus Medical University, Salzburg, Austria
  • 2Institute of Systems Sciences, University of Linz, Austria
  • 3Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Austria
  • 4Institute of Physiological Chemistry, Center for Physiological Medicine; Medical University of Graz, Austria

Introduction: Ischemia-reperfusion is a main cause of oxidative stress during coronary artery bypass grafting and subsequently a risk factor for arterial fibrillation (AF).

Methods: We investigated the antioxidative effect of a vitamin cocktail composed of ascorbic acid (Mel-C®) and alpha-tocopherole (Tocovenös®) as well as supplementation with omega-3-fatty acids (Omegaven®). All registered products were purchased from Fresenius-Kabi, Graz, Austria. Subjects (n=75) were divided into Controls (C=20), Vitamins (V=19), Poly-unsaturated fatty acids [PUFAs] (O=19) and PUFAs plus Vitamins (VO=17).

Results: Peroxides remained unchanged in the C- and O-group in contrast to vitamin-supplemented subjects, where these peroxides were significantly decreased. This effect was time limited and no longer present 24 hours after surgery. This coincided with a significant consumption of water- and lipid-soluble antioxidants. Peroxidase activity was decreased compared to baseline levels in V- and VO-subjects between 24 and 48 hours, whereas the enzyme activity remained unchanged in controls and PUFAs. Reduced titres of antibodies against oxidized LDL (oLAb) were associated with high levels of peroxides in the C- and O-groups. Due to the small number of cases we did not see significant differences either with respect to AF or in the duration of this complication. Nevertheless, there were indications that poly-unsaturated fatty acids are effective against AF, due to the lowest number of cases in the O-group and the shortest duration in the VO-group.

Conclusion: The administration of a vitamin cocktail significantly decreased the production of harmful peroxides. This was also reflected by lower peroxidase activity and increased oLAb titers even in the most critical period, i.e. 24 to 48 hours after intervention, as indicated by a distinct consumption of water- and lipid-soluble antioxidants. The indicative effect of PUFAs on the improvement of AF is currently under investigation with a larger number of cases.