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Background —In the presence of atherosclerosis, the coronary endothelial vasomotor response to acetylcholine is frequently abnormal but is variable between patients. We tested the hypothesis that the plasma concentration of α-tocopherol is associated with the preservation of nitric oxide–mediated endothelium-dependent vasomotion.Methods and Results —We studied 15 men and 6 women (mean age 61±10 years) at coronary angiography who were not taking vitamin supplements. Coronary endothelium-dependent and -independent vasomotion was assessed by intracoronary infusions of acetylcholine and nitroglycerin. The vasomotor responses were compared with the plasma concentration of α-tocopherol and the plasma α-tocopherol concentration relative to total lipid (total cholesterol plus triglycerides). The mean plasma α-tocopherol was 25.6±6.1 μmol/L, total cholesterol 193±27 mg/dL, triglycerides 115±66 mg/dL, and α-tocopherol to total lipid 4.2±0.9 μmol · L−1 · (mmol/L)−1 . The mean vasomotor response to acetylcholine was −1% (range −33% to 28%) and to nitroglycerin 22% (range 0% to 54%). Plasma α-tocopherol was significantly correlated with the acetylcholine response (r =0.49,P &lt;0.05) but not the nitroglycerin response (r =0.13,P &gt;0.05). The acetylcholine response remained significant after adjustment for other potential sources of oxidant stress (total cholesterol, diabetes mellitus, smoking, angina class) (P &lt;0.01). The relative concentration of α-tocopherol to total lipid was not related to endothelial function (r =0.24,P =0.3, n=20).Conclusions —α-Tocopherol may preserve endothelial vasomotor function in patients with coronary atherosclerosis. This effect may be related primarily to the action of α-tocopherol in the vascular wall. Further studies that assess the impact of α-tocopherol supplementation as therapy of endothelial dysfunction are justified.

Plasma α-Tocopherol and Coronary Endothelium-Dependent Vasodilator Function