Comparative efficacy of tocotrienol and tocopherol (vitamin E) on atherosclerotic cardiovascular diseases in humans

Abstract

Objectives: To compare the efficacy of tocotrienol and tocopherol in the management of patients with atherosclerotic cardiovascular diseases. Method: The systematic review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines 2020, and comprised literature search from 2002 till January 5, 2023, on PubMed, Google Scholar, Cochrane Library, Google, Wiley-Inter Science Library, Medline, SpringerLink and Taylor and Francis databases. The search was conducted using key words, such as: “tocopherol”, “tocotrienol”, “vitamin E”, “dyslipidaemia”, “cardiovascular diseases” “cardioprotective”, “hypercholesterolemia” and “atherosclerosis” along with Boolean operators. Human clinical studies regarding the use of tocotrienol or tocopherol or comparison of its efficacy in patients having atherosclerosis, dyslipidaemia leading to cardiovascular diseases, and studies including details of efficacy of any of the four alpha, beta, gamma, delta isomers of tocopherol or tocotrienol were included. Pertinent data from the eligible studies was retrieved and reviewed. Results: Of the 516 articles identified, 12(2.3%) were subjected to detailed analysis. Tocotrienol showed better anti-oxidant efficacy by decreasing inflammatory biomarkers, normalising serum lipid parameters and modulating micro-ribonucleic acid involved in cardiovascular diseases. Tocopherol shown heterogeneity of results by either decreasing or increasing the risk of mortality in atherosclerotic cardiovascular diseases. Conclusion: Compared to tocopherol, tocotrienol was found to be safe and potential candidate for improving cardiovascular health in the management of atherosclerotic cardiovascular diseases. Key Words: Cardiovascular diseases, Vitamin E, Atherosclerosis, Tocotrienol, Dyslipidaemia, Tocopherol, Hypercholesterolemia, Human studies.