Protective effects of tocotrienols in cerebral and myocardial ischemia-reperfusion injury: A systematic review

Although the current treatments for stroke and myocardial infarction contribute to an improvement in mortality rates, the consequences of reperfusion therapy have remained a challenge. Tocotrienols have been shown to exert beneficial effects on the brain and heart. This review aimed to determine the effects of tocotrienols in cerebral and myocardial ischemia-reperfusion (I/R) injury. We retrieved articles from Scopus, MEDLINE and PubMed from inception to June 2021, and included any studies using tocotrienols as a treatment for cerebral or myocardial I/R injury therapy. Observational studies and review articles were excluded, and the risk of bias was conducted using a specific tool for animal study (SYRCLE). The data were analyzed qualitatively. Twelve articles met the eligibility criteria. Tocotrienols significantly improved the structural, functional, and biochemical parameters in both cerebral and myocardial I/R injury models. In contrast, oxidative stress, inflammation, and apoptosis were markedly attenuated by tocotrienol treatment. Limitations to the analysis included marked differences in animal models, disease inductions, forms of tocotrienols, and an unclear risk of bias in certain types of bias. However, tocotrienols have the potential to serve as a supplement for reducing the impact of reperfusion injury.