Antioxidant supplementation enhances antioxidant capacity and mitigates oxidative damage following acute ischaemic stroke

Objective: To test whether supplementary antioxidants immediately following acute ischaemic stroke will enhance antioxidant capacity and mitigate oxidative damage. Design: A randomised controlled trial. Setting: A university teaching hospital. Subjects: A total of 48 acute ischaemic stroke patients within 12 h of symptom onset. Intervention: Daily oral 800 IU (727 mg) of alpha-tocopherol and 500 mg of vitamin C (n = 24), or no treatment (n = 24) for 14 days. Treatment group and controls were matched for stroke subtype and age. Main outcome measures: alpha-Tocopherol, ascorbic acid, total antioxidant capacity (TAOC), plasma malondialdehyde (MDA) and C-reactive protein (CRP) before treatment, at day 7 and day 14 following recruitment. Results: In all, 14 days of vitamin supplementation significantly improved plasma alpha-tocopherol and ascorbic concentrations in the treatment group compared with the decrease seen in the control group (P < 0.005 for difference in cumulative changes). TAOC increased significantly in the treatment group compared with controls (P < 0.003). There was a significant reduction in plasma MDA concentration in the treatment group, in contrast to the increase seen in the control group (P < 0.002). After adjusting for clinical complications CRP concentrations within 90 days postinfarct were significantly lower in the treatment group compared with controls. Conclusion: Supplementation with antioxidant vitamins within 12 h of onset of acute ischaemic stroke increased antioxidant capacity, reduced lipid peroxidation products and may have an anti-inflammatory effect. Sponsorship: Sheffield Teaching Hospital NHS Trust.