Vitamin C and cardiac disorders
by Harri Hemilä
- Meta-analyses
and re-analyses
- Flaws
in the analyses on vitamin C and cardiac disorders by other authors
- Flawed
controlled trials on vitamin C and cardiovascular diseases
- Flawed
Mendelian randomization studies on vitamin C and cardiovascular diseases
Meta-analyses
and re-analyses
Rozemeijer
S, Hemilä H, van Baaren M, de Man AME.
Vitamin C may reduce troponin
and CKMB levels after PCI and CABG: a meta-analysis.
BMC Cardiovasc
Disord. 2023
https://doi.org/10.1186/s12872-023-03459-6
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc10512653
Hemilä H,
Chalker E, de Man AME.
Vitamin C may improve
left ventricular ejection fraction: a meta-analysis.
Front Cardiovasc Med. 2022
https://doi.org/10.3389/fcvm.2022.789729
https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8913583
Hemilä H, Suonsyrjä T.
Vitamin C for preventing
atrial fibrillation in high risk patients: a systematic review and
meta-analysis.
BMC Cardiovascular Disorders 2017
https://doi.org/10.1186/s12872-017-0478-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5286679
-
An early version of the above text was prepared for a Cochrane review
-
Hemilä H, Suonsyrjä T.
-
Vitamin C for treating
atrial fibrillation
-
https://www.mv.helsinki.fi/home/hemila/H/2015_vitC_AF_draft.pdf
-
That version was rejected with a statement:
-
"Reason
for withdrawal from publication: The CRG withdrew this protocol as the
current author team is unable to progress to the final stage of the
review. The editors
consider this title as low priority for the current portfolio of
the Heart Group and therefore this title is not open to a new author
team."
-
https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011471.pub2/abstract
-
Thus,
our Cochrane review draft found a 45% decrease (95% CI 33% - 56%) in
post-operative AF in 8 non-US studies (Analysis 1.2, page 57 of the
draft), yet such a
finding has low priority in Cochrane Collaboration.
-
The actual reasons for rejection were not described, see the final
reviewer comments and our responses:
-
https://www.mv.helsinki.fi/home/hemila/H/vitC_AF_1308_reviewer_comments.pdf
-
See the protocol on which the review was based:
- https://www.mv.helsinki.fi/home/hemila/H/HH_2015_CochAF_Protocol.pdf
Hemilä H.
Publication bias in
meta-analysis of ascorbic acid for postoperative atrial fibrillation.
American Journal for Health System Pharmacy 2017;74(6):372-373.
https://doi.org/10.2146/ajhp160999
https://www.mv.helsinki.fi/home/hemila/H/2017_L_AJHP.pdf
Flaws
in the analyses on vitamin C and cardiac disorders by other authors
These
meta-analyses have some shortcomings but the shortcomings do no
invalidate the conclusion that there is strong evidence that vitamin C
has effects on AF. Thereby these meta-analyses are consistent with the
conclusions of the meta-analysis by Hemilä and Suonsyrjä (2017), that
vitamin C has effects on cardiac disorders in some conexts.
Flaws in the inclusion of trials and in referring to earlier meta-analyses
Pubpeer
https://pubpeer.com/publications/3C3BC7155720D6313E0A0EB6091A7B
- Comments on:
- Khan SA et al. (2020)
- Vitamin
C for cardiac protection during percutaneous coronary intervention: a
systematic review of randomized controlled trials.
- Nutrients. 2020
- https://pubmed.ncbi.nlm.nih.gov/32718091
Vitamin
C for cardiac surgery patients: several errors in a published
meta-analysis. Comment on “Effects of vitamin C on
organ function in cardiac surgery patients: a systematic review and
meta-analysis..
Nutrients 2019, 11, 2103”.
Hemilä H, Chalker E.
Nutrients 2020
https://www.mdpi.com/2072-6643/12/2/586/htm
See the Supplementary
file for more details
https://www.mdpi.com/2072-6643/12/2/586/s1
- Comments on:
- Hill et al. (2019)
- Effects of vitamin C on
organ function in cardiac surgery patients: a systematic review and
meta-analysis.
- Nutrients 2019
- https://pubmed.ncbi.nlm.nih.gov/31487905
Misleading review on vitamin C and cardiac patients
Pubpeer
https://pubpeer.com/publications/DEBED5D9F498A0C940E18841C25C75
- Comments on:
- Hill A et al. (2018)
- Vitamin C to improve
organ dysfunction in cardiac surgery patients-review and pragmatic
approach.
-
Nutrients 2018
- https://www.mdpi.com/2072-6643/10/8/974
Random-Effects
Assumption in Meta-analyses.
Hemilä H.
JAMA. 2019
https://doi.org/10.1001/jama.2019.5439
https://www.ncbi.nlm.nih.gov/pubmed/31265091
- Comments on:
-
Shi R et al. (2018)
- Sole
and combined vitamin C supplementation can prevent postoperative atrial
fibrillation after cardiac surgery: A systematic review and
meta-analysis of randomized controlled trials.
- Clin Cardiol. 2018
- https://www.ncbi.nlm.nih.gov/pubmed/29603289
Errors in a
meta-analysis on vitamin C and post-operative atrial fibrillation.
Hemilä
H.
Int J Surg. 2019
https://doi.org/10.1016/j.ijsu.2019.01.025
https://www.ncbi.nlm.nih.gov/pubmed/30831247
- Comments on:
- Hu et al. (2017)
- Efficacy
and safety of vitamin C for atrial fibrillation after cardiac surgery:
A meta-analysis with trial sequential analysis of randomized controlled
trials.
- Int J Surg. 2017
- https://www.ncbi.nlm.nih.gov/pubmed/27956113
Publication bias in meta-analysis of ascorbic acid for postoperative atrial fibrillation
Hemilä H
Am J Health Syst Pharm. 2017
https://doi.org/10.2146/ajhp160999
- Comments on:
-
Baker and Coleman (2016)
- Meta-analysis of ascorbic
acid for prevention of postoperative atrial fibrillation after cardiac
surgery.
- Am J Health Syst Pharm. 2016
- https://www.ncbi.nlm.nih.gov/pubmed/27806938
Flawed
controlled trials on vitamin C and cardiovascular diseases
Hemilä
H.
Gültekin (2021) paper has a substantial number of identical data
with the 20-year earlier Demirag (2001) paper
Pubpeer 2022 Feb
https://pubpeer.com/publications/8150B66EC0289FA4BF7C9ADB1C48A9
- Comments on:
- Gültekin Y, Güzel A, Karakaya A, Beşoğul Y.
- Combined effects of the implementation of magnesium and ascorbic acid on myocardial ischemia-reperfusion in open heart surgery.
- Anatolian Current Medical Journal. 2021;3(4):319-26.
- https://doi.org/10.38053/acmj.982137
Hemilä H.
Statistical problems in the vitamin C trial with PCI patients
by Shafaei-Bajestani et al. (2019)
Pubpeer 2022 Feb
https://pubpeer.com/publications/1B59AD863839D55215841C1124C2D3
- Comments on:
- Shafaei-Bajestani N, Talasaz AH, Salarifar M, Pourhosseini H, Sadri F, Jalali A.
- Potential
role of vitamin C intracoronary administration in preventing cardiac
injury after primary percutaneous coronary intervention in patients
with ST-elevation myocardial infarction.
- J Res Pharm Pract. 2019;8(2):75-82.
- https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6636420
- https://pubmed.ncbi.nlm.nih.gov/31367642
Hemilä H.
Statistical problems in the vitamin C trial with CABG patients by Moludi et al. (2020)
Pubpeer 2022 Feb
https://pubpeer.com/publications/2E9E504061A7DC2AF6B2692D8632F1
- Comments on:
- Moludi J, Alizadeh M, Chehri G, Jafari-Vayghyan H, Foroumandi E, Maleki V, Ebrahimi B, Sadeghpour A, Alizadehasi A, Tabaee AS.
- The
effect of vitamin C supplementation on cardiac enzymes after coronary
artery rypass graft: a double-blind bandomized control trial.
- Current Nutrition & Food Science. 2020;16(5):833-8.
- https://doi.org/10.2174/1573401315666190712213051
Flawed
Mendelian randomization studies on vitamin C and cardiovascular diseases
Hemilä H, Chalker E.
Vitamin C and the risk of
atrial fibrillation: Mendelian randomization study may be misleading.
Clin
Nutr. 2022
https://doi.org/10.1016/j.clnu.2022.04.029
- Comments on:
- Chen L, Sun X, Wang Z, Lu Y, Chen M, He Y, Xu H, Zheng L.
- The
impact of plasma vitamin C levels on the risk of cardiovascular
diseases and Alzheimer's disease: A Mendelian randomization study.
- Clin Nutr. 2021;40(10):5327-5334.
- https://pubmed.ncbi.nlm.nih.gov/34537655
Hemilä H, Chalker E.
Vitamin C and the risk of
cardiovascular diseases: Mendelian randomization study may be
misleading.
Eur J Prev Cardiol. 2022
https://doi.org/10.1093/eurjpc/zwac067
- Comments on:
- Yuan S, Zheng JS, Mason AM, Burgess S, Larsson SC.
- Genetically predicted circulating vitamin C in relation to cardiovascular disease.
- Eur J Prev Cardiol. 2022;28(16):1829-1837.
- https://pubmed.ncbi.nlm.nih.gov/34057996