Why the study?
Although PCI restores blood flow in ACS or stable angina, reperfusion increases oxidative stress, raising the question of whether intravenous vitamin C prior to PCI provides cardioprotection.
Does vitamin C administration prior to PCI reduce myocardial injury and oxidative stress in patients with acute coronary syndrome or stable angina?
Does vitamin C administration prior to PCI reduce myocardial injury and oxidative stress in patients with acute coronary syndrome or stable angina?
Intravenous vitamin C prior to PCI may reduce periprocedural myocardial injury and oxidative stress, though its impact on long-term cardiac function remains inconclusive.
May support pre-PCI IV vitamin C for cardioprotection; extends biomarker evidence on oxidative stress to reperfusion settings.
Percutaneous coronary intervention (PCI) is the preferred treatment for acute coronary syndrome (ACS) secondary to atherosclerotic coronary artery disease. This nonsurgical procedure is also used for selective patients with stable angina. Although the procedure is essential for restoring blood flow, reperfusion can increase oxidative stress as a side effect. We address whether intravenous infusion of vitamin C (VC) prior to PCI provides a benefit for cardioprotection. A total of eight randomized controlled trials (RCT) reported in the literature were selected from 371 publications through systematic literature searches in six electronic databases. The data of VC effect on cardiac injury biomarkers and cardiac function were extracted from these trials adding up to a total of 1185 patients. VC administration reduced cardiac injury as measured by troponin and CK-MB elevations, along with increased antioxidant reservoir, reduced reactive oxygen species (ROS) and decreased inflammatory markers. Improvement of the left ventricular ejection fraction (LVEF) and telediastolic left ventricular volume (TLVV) showed a trend but inconclusive association with VC. Intravenous infusion of VC before PCI may serve as an effective method for cardioprotection against reperfusion injury.
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Khan et al. (2020) studied this question.
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