Acute effects of vitamin C on platelet responsiveness to nitric oxide donors and endothelial function in patients with chronic heart failure

Gethin R. Ellis, Richard A. Anderson, Yuliy Y. Chirkov, Jayne Morris-Thurgood, Simon K. Jackson, Malcolm J. Lewis, John D. Horowitz, Michael P. Frenneaux

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46 Citations (Scopus)


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
Original languageEnglish
Pages (from-to)564-570
Number of pages7
JournalJournal of Cardiovascular Pharmacology
Issue number5
Publication statusPublished - May 2001


  • Adult
  • Aged
  • Analysis of Variance
  • Antioxidants
  • Ascorbic Acid
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Endothelium, Vascular
  • Female
  • Heart Failure
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Nitric Oxide Donors
  • Nitroglycerin
  • Nitroprusside
  • Oxidative Stress
  • Platelet Aggregation
  • Vasodilator Agents

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