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 12h of symptom onset. Intervention: Daily oral 800IU (727mg) of α-tocopherol and 500mg 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: α-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 α-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). Conclusion: Supplementation with antioxidant vitamins within 12h of onset of acute ischaemic stroke increased antioxidant capacity, reduced lipid peroxidation products and may have an anti-inflammatory effect.