Antioxidant Vitamins in the Prevention of Atrial Fibrillation: What Is the Evidence?

Table 2

Summary of clinical evidence for the use of antioxidant vitamins in AF prevention.

Study	Design	N	Setting	Groups	Endpoint	Follow up	Risk reduction
Sisto et al. 1995 [42]	RCT	81	CABG	Vitamin C/vitamin E/allopurinol versus placebo	Arrhythmias (including AF)	5 days postoperative	30% absolute risk reduction (𝑃=0.05)
Carnes et al. 2001 [15]	Double-blinded, placebo controlled RCT	86	CABG	Ascorbic acid versus control	AF detection	5 days postoperative	18.6% absolute risk reduction (𝑃=0.048).
Lassnigg et al. 2003 [43]	Double-blinded RCT	40	CABG/valve surgery	all-rac-α-tocopherol versus placebo	Arrhythmias (including AF)	6 days postoperative	No effect of vitamin E on AF
Korantzopoulos et al. 2005 [44]	Double-blinded RCT	44	DCCV for persistent AF	Vitamin C versus placebo	AF recurrence	1 week post successful DCCV conversion	31.8% absolute risk reduction (𝑃=0.024)
Eslami et al. 2007 [45]	RCT	100	CABG	𝛽-blockers + ascorbic acid versus 𝛽-blockers alone	AF detection	4 days postoperative	22% relative risk reduction (𝑃=0.002)
Hicks et al. 2007 [46]	Double-blinded RCT	32	MI—for thrombolysis	Antioxidant vitamins (A, C, B complex, vitamin E) versus placebo	New-onset AF	2 hours post thrombolysis	38% absolute risk reduction (𝑃<0.05)
Papoulidis et al. 2010 [12]	RCT	170	CABG	Vitamin C versus placebo	AF and rhythm restoration from AF	5 days postoperative	16.5% absolute risk reduction (𝑃=0.04) Reduced ICU stay (𝑃=0.05), reduced hospitalisation time (𝑃=0.04) and reduced time needed for conversion into SR (𝑃=0.047)
Castillo et al. 2010 [47]	Double-blinded RCT	95	CABG	n-3 PUFA/Vitamin C and E versus placebo	AF detection	Hospital discharge	9% absolute risk reduction (𝑃=0.32)

AF: atrial fibrillation; RCT: randomised controlled trial; CABG: coronary artery bypass graft; DCCV: direct current cardioversion; MI: myocardial infarction; ICU: intensive care unit; SR: sinus rhythm; n-3 PUFA: omega 3 polyunsaturated fatty acids.