Vitamin C revisited

Table 2 Controlled studies on the effect of vitamin C in cardiac surgery patients

Study	Design	Intervention	Number of patients	Incidence of new POAF (%)	Pvalue	Other clinical benefits
Dingchao and colleagues [101]	Controlled; patients undergoing cardiopulmonary bypass	i.v. vitamin C; 250 mg/kg i.v. before	45			MDA ↓; CK, CK-MB ↓; postbypass defibrillation 0 vs. 12.5 %; CI ↑, LOS ICU ↓, LOS hospital ↓
		Control	40
Carnes and colleagues [82]	Matched control; CABG	Oral vitamin C; 2 g night before, 500 mg daily for 5 days	43	16.3	0.048
		Matched control	43	34.9
Eslami and colleagues [98]	RCT; CABG	β-Blocker + oral vitamin C; 2 g night before, 1 g twice daily for 5 days	50	4	0.002
		β-Blocker alone	50	26
Bjordahl and colleagues [99]	RCT; CABG	Oral vitamin C; 2 g night before, 1 g twice daily for 5 days	89	30.3	0.985	Shorter time on ventilator, 1.2 vs. 1.4 days, P = 0.032
		Placebo	96	30.2
Papoulidis and colleagues [100]	RCT; CABG	i.v. vitamin C; 2 g 3 hours before CPB	85	44.7	0.041	Time to SR conversion ↓, LOS hospital ↓, LOS ICU ↓
		i.v. saline	85	61.2
Rodrigo and colleagues [95]	RCT	Preoperative PUFA; 2 g/day for 5 days; vitamin C 1 g/day + vitamin E 400 IU/day for 2 days preoperatively and postoperatively until discharge	103	9.7	<0.001	Oxidative stress-related biomarkers in atrial tissue ↓
		Placebo^a	100	32

CABG, coronary artery bypass surgery; CI, cardiac index; CK, creatinine phophokinase; CK-MB, creatinine phosphokinase muscle, brain isoenzyme; CPB, cardiopulmonary bypass; i.v., intravenously; LOS, length of stay; MDA, malondialdehyde; POAF, postoperative atrial fibrillation; PUFA, ω-3 polu-unsaturated fatty acids containing eicosapentaenoic and docosahexaenoic acids in a 1:2 ratio; RCT, randomized controlled trial; SR, sinus rhythm; ↑, increase; ↓, decrease; =, constant. ^aPlacebo contained 500 mg inert microgranules, 825 mg triglycerides and 500 mg vegetable oil per capsule.

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