Document Detail


Oral vitamin C administration reduces early recurrence rates after electrical cardioversion of persistent atrial fibrillation and attenuates associated inflammation.
MedLine Citation:
PMID:  15982504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Inflammation and oxidative stress have been recently implicated in the pathophysiology of atrial fibrillation (AF). The aim of this study was to examine the potential benefit of vitamin C on the early recurrence rates and on inflammatory indices after successful cardioversion of persistent AF, as well as to investigate the time course of changes in these indices post-cardioversion. METHODS: We prospectively studied 44 consecutive patients after successful electrical cardioversion of persistent AF. All patients received standard treatment and were randomised in one to one fashion to either oral vitamin C administration or no additional therapy. We followed-up the patients for 7 days performing successive measurements of white blood cell (WBC) count, C-reactive protein (CRP), fibrinogen, and ferritin levels. RESULTS: One week after successful cardioversion, AF recurred in 4.5% of patients in the vitamin C group and in 36.3% of patients in the control group (p=0.024). Compared to baseline values, inflammatory indices decreased after cardioversion in patients receiving vitamin C but did not change significantly in the control group. A significant variance was found in the serial measurements of WBC counts (F=5.86, p=0.001) and of fibrinogen levels (F=4.10, p=0.0084) in the two groups. In the vitamin C group CRP levels were lower on the seventh day (p<0.05). CRP and fibrinogen levels were higher in patients who relapsed into AF compared to patients who maintained sinus rhythm (F=2.77, p=0.044 and F=3.51, p=0.017, respectively). CONCLUSIONS: These findings suggest that vitamin C reduces the early recurrence rates after cardioversion of persistent AF and attenuates the associated low-level inflammation. These effects indicate that therapeutic approaches targeting at inflammation and oxidative stress may exert favourable effects on atrial electrical remodeling.
Authors:
Panagiotis Korantzopoulos; Theofilos M Kolettis; Evaggelos Kountouris; Vasiliki Dimitroula; Pavlos Karanikis; Eugenia Pappa; Konstantinos Siogas; John A Goudevenos
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  International journal of cardiology     Volume:  102     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-06-28     Completed Date:  2005-10-24     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  321-6     Citation Subset:  IM    
Affiliation:
Department of Cardiology, G. Hatzikosta General Hospital, 45001 Ioannina, Greece. pkor@oneway.gr
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Antioxidants / administration & dosage*
Ascorbic Acid / administration & dosage*
Atrial Fibrillation / epidemiology,  physiopathology,  therapy*
Biological Markers / blood
C-Reactive Protein / metabolism
Echocardiography
Electric Countershock / adverse effects*
Electrocardiography / drug effects
Female
Ferritins / blood
Fibrinogen / metabolism
Follow-Up Studies
Heart Atria / ultrasonography
Humans
Incidence
Inflammation / blood,  drug therapy,  etiology
Leukocyte Count
Male
Myocarditis / blood,  drug therapy*,  etiology
Nephelometry and Turbidimetry
Oxidative Stress / physiology
Prospective Studies
Recurrence / prevention & control
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antioxidants; 0/Biological Markers; 50-81-7/Ascorbic Acid; 9001-32-5/Fibrinogen; 9007-41-4/C-Reactive Protein; 9007-73-2/Ferritins
Comments/Corrections
Comment In:
Int J Cardiol. 2005 Oct 10;104(3):361-2   [PMID:  16087256 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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