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THE IMPORTANCE OF
VITAMIN C IN THE INCIDENCE
OF ATRIAL FIBRILLATION
By Kathryn Buchanan Keller, RN, PhD, and Louis Lemberg, MD
A
c. vitamin C may play a role in prevent-
nary atherosclerotic heart disease was ing postoperative AF
admitted for elective coronary revascu- d. atrial remodeling may be caused by
larization. He had a history of chronic oxidative stress
obstructive pulmonary disease due to
cigarette smoking and essential hypertension. He was ANSWERS
managed on diuretics and a salt-poor, low-cholesterol 1. b. vitamin C deficiency increases mortality
diet. An echocardiogram revealed left ventricular c. vitamin C deficiency is common in dia-
hypokinesis and atrial enlargement. Wide and notched betics
P waves in standard leads II and III of the electrocar- e. in the past, vitamin C was synthesized
diogram were considered to be related to his chronic by humans
obstructive pulmonary disease, which put him at risk Vitamin C (ascorbic acid) is an essential element
for postoperative atrial fibrillation (AF). A cardiac in the adult population. It is a cofactor in enzymatic
consultant advised adding vitamin C (ascorbic acid) functions necessary for metabolic reactions, such as
to his management. biosynthesis of collagen, amino acids, and norepi-
nephrine. Vitamin C is a powerful antioxidant that
QUESTIONS protects cellular constituents (proteins, lipids, and
1. Which of the following statements regarding DNA) and protects against oxidative stress produced
vitamin C is/are correct? by peroxide and free radicals.1 Vitamin C is found
a. vitamin C deficiency is rare in developed in fruits and vegetables and synthesized by most
countries living creatures. Humans and the higher primates
b. vitamin C deficiency increases mortality lost this function millions of years ago and are now
c. vitamin C deficiency is common in dia- dependent on exogenous sources of this essential
betics nutrient. Although scurvy, a disease of severe vitamin
d. vitamin C can be toxic in high doses C deficiency, is rarely seen in developed nations,
e. in the past, vitamin C was synthesized prevalence of vitamin C deficiency has been found
by humans in the adult population of the United States. Low
vitamin C serum concentrations were found in 25%
2. Which of the following are correct? of noncigarette smoking adult men 60 to 74 years
a. atrial fibrillation is an expected, benign of age.2 The incidence in the younger population
postoperative complication has been less striking, but not insignificant.3
b. -blockers are effective in preventing Vitamin C requirements increase during
postoperative AF trauma or injury, reflecting an increase in vitamin
270 AJCC AMERICAN JOURNAL OF CRITICAL CARE, May 2008, Volume 17, No. 3 www.ajcconline.org
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