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Type: Journal article
Title: Acute effects of vitamin c on platelet responsiveness to nitric oxide donors and endothelial function in patients with chronic heart failure
Author: Ellis, G.
Anderson, R.
Chirkov, Y.
Morris-Thurgood, J.
Jackson, S.
Lewis, M.
Horowitz, J.
Frenneaux, M.
Citation: Journal of Cardiovascular Pharmacology, 2001; 37(5):564-570
Publisher: Lippincott Williams & Wilkins
Issue Date: 2001
ISSN: 0160-2446
Statement of
Gethin R. Ellis, Richard A. Anderson, Yuliy Y. Chirkov, Jayne Morris-Thurgood, Simon K. Jackson, Malcolm J. Lewis, John D. Horowitz, and Michael P. Frenneaux
Abstract: Chronic heart failure (CHF) is characterized by a prothrombotic state, which may relate to increased platelet aggregability, endothelial dysfunction, and increased oxidative stress. We investigated the effect of vitamin C in CHF on ex vivo platelet aggregation and platelet responsiveness to the anti-aggregatory effects of the nitric oxide (NO) donors glyceryl trinitrate (GTN) and sodium nitroprusside (SNP). We also examined parameters of oxidative stress and endothelial function in patients. In this double-blind, randomized, crossover study vitamin C (2 g) or placebo was given intravenously to 10 patients with CHF. We measured adenosine 5-diphosphate (ADP)-induced platelet aggregation, flow-mediated dilatation (FMD) in the brachial artery using ultrasonic wall-tracking, and plasma levels of lipid-derived free radicals using electron paramagnetic resonance spectroscopy. Vitamin C did not affect ex vivo platelet aggregability but enhanced the inhibition of platelet aggregation by SNP (62.7+/-10.2 to 82.7+/-4.8%, p = 0.03) and tended to increase responses to GTN (40.5+/-9.0 to 53.4+/-7.3, p = 0.06). The effect of vitamin C on platelet responsiveness to the antiaggregatory effects of SNP was inversely related to basal response to SNP (r = -0.9, p < 0.01); a similar trend was observed with GTN (r = -0.6, p = 0.1). Vitamin C also increased FMD (1.9+/-0.6 to 5.8+/-1.5%, p = 0.02) and reduced plasma lipid-derived free radicals by 49+/-19% (p < 0.05). In patients with CHF acute intravenous administration of vitamin C enhances platelet responsiveness to the anti-aggregatory effects of NO donors and improves endothelial function, suggesting a potential role for vitamin C as a therapeutic agent in CHF.
Keywords: Endothelium, Vascular
Chronic Disease
Ascorbic Acid
Nitric Oxide Donors
Vasodilator Agents
Analysis of Variance
Linear Models
Cross-Over Studies
Double-Blind Method
Oxidative Stress
Platelet Aggregation
Middle Aged
Heart Failure
Description: © 2001 Lippincott Williams & Wilkins, Inc., Philadelphia
DOI: 10.1097/00005344-200105000-00008
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