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To the Editor: In their randomized controlled trial, Dr Sesso and colleagues¹ tested the hypothesis that antioxidant supplements could reduce the risk of a composite end point of nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. Patients were randomly allocated to antioxidant treatment (400 IU of vitamin E every other day or 500 mg of vitamin C daily) or to placebo and followed up for 8 years. During the follow-up neither vitamin E nor vitamin C reduced the risk of major cardiovascular events, suggesting that these supplements are not indicated to prevent atherosclerotic progression and its vascular complications. This finding is in line with the majority of interventional trials with antioxidants showing that antioxidants such as vitamins E and C are unable to influence vascular outcome in patients at risk of or with previous cardiovascular disease.²

However, potential confounding factors should be considered. Based on recent data suggesting that statins . . . [Full Text of this Article]

Francesco Violi, MD
francesco.violi@uniroma1.it

Roberto Cangemi, MD
Department of Experimental Medicine
University of Rome "La Sapienza"
Rome, Italy

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