ClinicalTrials.gg
Not yet recruitingNCT06995586Updated May 13, 2026

Dietary Supplements in Patients With Coronary Artery Bypass Grafting for Improving the Quality of Healthcare Delivery.

An interventional study of Vitamin C, Omega 3 PUFA (EPO/DHA), Lignin, Lactulose in Cardio-pulmonary Bypass, Cardiovascular Diseases and Omega-3 Polyunsaturated Fatty Acids, sponsored by Nicosia General Hospital. Not yet recruiting at 1 site in Cyprus. Open to participants aged 40 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-05-13.

Sponsored by Nicosia General Hospital · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
108
Allocation
Randomized
Ages
40 Years to 80 Years
Sex
All
01

Study summary

Cardiovascular disease (CVD) remains the leading cause of death worldwide. Prevention of CAD by targeting modifiable factors remains a key public health priority. L-Ascorbic Acid (Vitamin C - Vit. C) and Omega 3 fatty acids, Eicosapentaenoic / Docosahexaenoic Acid (EPO/DHA), powerful but also necessary antioxidants for the human body, after observational studies as well as randomized studies seem to have a beneficial effect in the direction of the prevention of CVD with pleiotropic mechanisms. Lignin, a polymer of plant origin that is considered a dietary fiber, has a developed porous structure and can retain exogenous and endogenous toxins, and pathogenic microorganisms. Lactulose considered a prebiotic provides a selective substrate for the metabolism of saccharolytic bacteria with bifidogenic activity and multiple benefits to the host's gut health. Coronary artery bypass grafting (CABG) is an established surgical intervention and treatment of symptoms of myocardial ischemia that improves patient survival Optimal Medical Therapy (OMT) after coronary arterial bypass grafting (CABG) as described in current clinical practice could be made even better by the addition of these beneficial food supplements.

A randomized controlled trial is proposed in an intervention group of 54 post-CABG patients who will be given daily orally in addition to the usual medication, 1000 mg Vitamin C, 840 mg EPO/DHA, 2130 mg Lignin \& 720 mg Lactulose and a control group of 54 patients (Control Group) in which only usual medication will be administered. The intervention will take place from the 15th postoperative day when CAGB patients are discharged and lasts for 2.5 months (10 weeks) postoperatively. The data will be collected on the 15th, 80-90th postop day in 6 months and 12 months postop and then the statistical analysis of the data will be performed. Considering the number of CABG surgeries performed electively in our clinic, this study is expected to be completed in approximately 2-3 years from the day of initiation.

The expected knowledge through the expected results such as these will emerge from this study is the potentially beneficial effect of our food supplements administration (intervention), i.e. Vitamin C, EPO/DHA, Lignin \& Lactulose, on the postoperative course of our patients. Some degree of improvement in the well-being and clinical picture of our patients postoperatively is expected, which will be thoroughly investigated in each phase of the study.

Read the detailed description

Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide. CVD is the result of disorders of the heart and blood vessels and includes cerebrovascular disease, coronary artery disease (CAD) and peripheral arterial disease. The main mechanism believed to cause CAD is atherosclerosis, in which the arteries become narrowed by plaques or atheroma. While arteries can naturally become harder and narrower with age, this process can be accelerated by factors such as smoking, high cholesterol, high blood pressure, obesity, a sedentary lifestyle and ethnicity. Prevention of CAD by targeting modifiable factors remains a key public health priority. Diet plays an important role in the etiology of many chronic diseases including CAD, thus contributing to a significant geographic variability in morbidity and mortality rates between different countries and populations worldwide. A number of dietary factors have been found to be associated with CAD risk and can be modified to reduce CAD risk with interventions aimed at CAD prevention and management. L-Ascorbic Acid (Vitamin C - Vit. C) and Omega 3 fatty acids, Eicosapentaenoic / Docosahexaenoic Acid (EPO/DHA), powerful but also necessary antioxidants for the human body, after observational studies as well as randomized studies seem to have a beneficial effect in the direction of the prevention of CVD with pleiotropic mechanisms. Lignin, a polymer of plant origin that is considered a dietary fiber, has a developed porous structure and can retain exogenous and endogenous toxins, and pathogenic microorganisms. Lactulose considered a prebiotic provides a selective substrate for the metabolism of saccharolytic bacteria with bifidogenic activity and multiple benefits to the host's gut health.

Objectives of the study: Our work, which is unique in its kind, is expected to highlight and help establish the administration of the proposed formulations (Vitamin C, EPO/DHA, Lignin, Lactulose) as an integral part of optimal medical therapy (OMT) after interventions in the coronary vessels. It will also form the basis for further research regarding the combined physiological mechanisms of action of the vitamins in question (Vitamin C, EPO/DHA, Lignin, Lactulose) both at the histological and cellular level.

Description of methods including collection and analysis: This is a randomized and controlled trial with an intervention group that will be administered orally daily in addition to the OMT, namely 1000 mg Vitamin C, 840 mg EPO/DHA, 2130 mg Lignin \& 720 mg Lactulose and a control group that will receive only the OMT. The intervention will take place from the 15th postoperative day (POD) when CAGB patients are discharged and lasts for 2.5 months (10 weeks) PO. The data will be collected on the 15th, 80-90th POD in 6 months and 12 months PO and then the statistical analysis of the data will be performed. Considering the number of CABG surgeries performed electively in our clinic, this study is expected to be completed in approximately 3 years from the day of its initiation. The subjects will be people 40-80 years old, with coronary artery disease, and mental clarity without any psychiatric, neurological or motor disorder who will undergo Coronary Aortic Bypass (CABG) in our clinic (Public Cardiothoracic Surgery clinic in Nicosia General Hospital) and will be randomized into 2 groups (intervention group and control group). A total of at least 108 subjects are required for both groups (54 in each group). In this way, a 40% incidence could be detected in the control group with a 16% incidence in the intervention group (Vitamin C, EPO/DHA, Lignin, Lactulose), i.e. a reduction of around 60% (Alpha 5%, Beta 20%, Power 80%). Once informed consent and written consent have been obtained from a subject and satisfactory inclusion and exclusion criteria have been verified, the individual will be assigned to a group and undergo physical examinations and laboratory blood tests to confirm their status. Each subject will be randomly assigned to each group using a random number generator that assigns each subject to each group in a blinded fashion. A questionnaire asking patients about their experience and opinion of the quality of our services and the patients' quality of life before and after surgery will also be distributed, as well as a consent form to enroll in the study. The data will be collected during the 1st to 4th PO appointment namely the 15th POD, the 80-90th POD in 6 months and 12 months PO in a database on a computer of our hospital and then the statistical analysis of the data will be carried out with the appropriate software. All appropriate parametric and non-parametric statistical analyzes will be performed accordingly (X2 test, Logistic Regression, Linear Regression, Analysis of Variance (ANOVA), Log Rank test, Cox hazard model, ROC curve, etc.). Appropriate statistical analysis software (IBM® SPSS®) will be applied and in addition, assistance from a specialist statistician will be requested for highly specialized analyses.

Project Innovation and Originality: OMT postoperatively (PO) is subject to improvement. One of these promising improvements is the addition of (Vitamin C, EPO/DHA, Lignin, Lactulose) proposed by the present study, for which the research in question is being carried out. As far as we know, the proposed study is the first of its kind internationally that studies the combined action of these 4 factors together, which makes it unique. Some degree of improvement in the well-being and clinical picture of our patients PO is expected, which will be thoroughly investigated in each phase of the study. In this way, both the theoretical framework around PO treatment and the clinical practice itself in which we propose to introduce the aforesaid complementary treatment will be improved.

Dissemination of findings: The results of our study, which is part of Dr. Athanasiou's doctoral thesis at the Open University of Cyprus under the supervision of Dr. Soteriades, will be shared and published both in the domestic and international scientific press and will be freely accessible through the servers of the Open University of Cyprus. There will be no royalties and no charge for acquiring the original work and publications.

02

Conditions studied

  • Cardio-pulmonary Bypass
  • Cardiovascular Diseases
  • Omega-3 Polyunsaturated Fatty Acids
  • Omega-3 Supplementation
  • Vitamin C
  • Supplements
  • Postoperative Depression
  • Antioxidants
  • Lactulose
  • Postoperative
  • Optimal Medical Therapy
  • CABG
  • Coronary Artery Bypass Grafting
  • Prebiotics

Keywords

  • Cardio-pulmonary Bypass
  • Cardiovascular Diseases
  • Omega-3 polyunsaturated fatty acids
  • Vitamin C
  • Antioxidants
  • Lactulose
  • Omega-3 supplementation
  • Supplements
  • postoperative
  • Optimal Medical Therapy
  • CABG
  • Coronary Artery Bypass Grafting
  • postoperative depression
  • Lignin
  • adsorbent
  • prebiotics
03

In context

Cardiovascular Diseases

5,368 studies on the registry are indexed under Cardiovascular Diseases; 939 are open to participants now.

This study's planned enrollment of 108 is close to the median of 100 across 3,084 interventional studies indexed under Cardiovascular Diseases.

Browse Cardiovascular Diseases studies →

Lead sponsor

Nicosia General Hospital is the lead sponsor of 3 studies on the registry; 2 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
40 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • The subjects will be people 40-80 years old, with coronary artery disease, and mental clarity who will undergo Coronary Aortic Bypass (CABG) in our clinic (Public Cardiothoracic Surgery clinic in Nicosia General Hospital) and will be randomized into 2 groups (intervention group and control group).
  • Signed consent form
  • Ability to adhere to the protocol

Exclusion criteria

Exclusion Criteria:

  • Any psychiatric, neurological or motor disorder.
  • to the components of the supplement.
  • Combined Cardiac Surgery other than CABG and valve or aortic
  • Concurrent participation in other clinical trials.
  • Previous use of any probiotics, prebiotics, adsorbent dietary supplements, Vitamin C and/or Omega 3 fatty acids.
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
108 participants (estimated)

Study arms

  • Experimental
    Intervention group (OMT & Supplements)

    This is a randomized and controlled trial with an intervention group that will be administered orally daily 1000 mg Vitamin C, 840 mg EPO/DHA, 2130 mg Lignin \& 720 mg Lactulose in addition to the Optimal Medical Therapy (OMT).

    Dietary Supplement: Vitamin C, Omega 3 PUFA (EPO/DHA), Lignin, Lactulose

  • No intervention
    Control group (OMT)

    This is a randomized and controlled trial with an intervention group and a control group that will receive only the Optimal Medical Therapy (OMT).

Interventions

  • Dietary supplementVitamin C, Omega 3 PUFA (EPO/DHA), Lignin, Lactulose

    Drug pages: Ascorbic Acid · Omega-3 fatty acid · Lactulose

    This is a randomized and controlled trial with an intervention group that will be administered orally daily in addition to the Optimal Medical Therapy (OMT), namely 1000 mg Vitamin C, 840 mg EPO/DHA, 2130 mg Lignin \& 720 mg Lactulose and a control group that will receive only the OMT.

06

What researchers measure

Primary outcomes

  1. Postoperative decrease in morbidity/mortality associated with our intervention complementary to OMT (Vit C, n-3 PUFA, Lignin and Lactulose)

    Optimal Medical Therapy (OMT) postoperatively (PO) is subject to improvement. One of these promising improvements is the addition of (Vitamin C, EPO/DHA, Lignin, Lactulose) proposed by the present study, for which the research in question is being carried out. As far as we know, the proposed study is the first of its kind internationally that studies the combined action of these 4 factors together, which makes it unique. Some degree of improvement in the well-being and clinical picture of our patients PO is expected, which will be thoroughly investigated in each phase of the study. In this way, both the theoretical framework around PO treatment and the clinical practice itself in which we propose to introduce the aforesaid complementary treatment will be improved.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

Secondary outcomes

  1. Overall Quality Assesment. Assesment of the quality of the service provided to the patients & overall quality of life of our patients postoperatively.

    There will be questionnaires assessing the perceived quality of our health service to the patient as well as objective/actual measurements about the overall quality of life of our patients postoperatively. These data will be assessed in 4 time points postoperatively.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  2. Postoperative Mental Status of the patients.

    There will be an internationally standardized questionnaire, namely "The Center for Epidemiologic Studies-Depression scale (CES-D Scale), about the mental status of our patients and it will be assessed in 4 time points postoperatively. The CES-D measures a well-being/depression continuum in adolescents, adults, and older adults. The CES-D total score provides an indication of depressive symptom severity that is based on a combination of the presence/absence of depressive experiences and the presence/absence of well-being. Possible range of scores is 0 to 60, with the higher scores indicating the presence of more symptomatology.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

Other outcomes

  1. Full blood count (FBC) examination postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have full blood count (FBC) blood test.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  2. Biochemical analysis postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have biochemical analysis blood test.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  3. C reactive protein (CRP) examination postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have C reactive protein (CRP) examination blood test.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  4. Echocardiographic examination postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have heart Echocardiography.

    Time frame: The data will be collected on the 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  5. Radiologic examinations postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have radiological examinations with a Chest X-ray.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

  6. Physical examination (weight measurement) postoperatively during the follow up period.

    Individuals who participate in this study will receive additional follow-up postoperatively for one year according to the protocol and have on site weight measurement in kilograms.

    Time frame: The data will be collected on the 15th, 80-90th postop day (POD) in 6 months and 12 months PO and then the statistical analysis of the data will be performed. This study is expected to be completed in approximately 3 years from the day of its initiation.

07

Study locations

1 site
08

References and documents

Publications

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  • Mozaffarian D, Stein PK, Prineas RJ, Siscovick DS. Dietary fish and omega-3 fatty acid consumption and heart rate variability in US adults. Circulation. 2008 Mar 4;117(9):1130-7. doi: 10.1161/CIRCULATIONAHA.107.732826. Epub 2008 Feb 19. PubMed 18285566 ↗
  • Fabian CJ, Kimler BF, Hursting SD. Omega-3 fatty acids for breast cancer prevention and survivorship. Breast Cancer Res. 2015 May 4;17(1):62. doi: 10.1186/s13058-015-0571-6. PubMed 25936773 ↗
  • Bodkowski, R., Patkowska-Sokola, B., Filip-Psurska, B., Kempinska, K., Wietrzyk, J., Czyz, K., ... & Usydus, Z. (2014). Evaluation of the anti-proliferative activity of natural lipid preparations against tumor cell lines. J. Anim. Vet. Adv, 13(4), 257-266. DOI:10.3923/javaa.2014.257.266
  • Tsao, C.S. An overview of ascorbic acid chemistry and biochemistry. In Vitamin C in Health and Disease; Packer, L., Fuchs, J., Eds.; Marcel Dekker Inc.: New York, NY, USA, 1997; pp. 25-58.
  • Hamabe A, Takase B, Uehata A, Kurita A, Ohsuzu F, Tamai S. Impaired endothelium-dependent vasodilation in the brachial artery in variant angina pectoris and the effect of intravenous administration of vitamin C. Am J Cardiol. 2001 May 15;87(10):1154-9. doi: 10.1016/s0002-9149(01)01485-0. PubMed 11356389 ↗
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Related links

Individual participant data

Plan to share: No

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Sep 2026; primary completion for Dec 2027, 15 months later.

Of 1,077 non-industry interventional studies with no phase under Cardiovascular Diseases, half reached primary completion within 26 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 48. This study's planned 15 months is below that.

Counting every sponsor, half of 1,216 studies reached it within 26 months; a quarter within 12 and three quarters within 49.

Cardiovascular Diseases covers many different conditions, not one, so the studies compared here vary widely. Read these figures as a rough guide.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 25, 2025
First posted
May 29, 2025
StartEst.
Sep 1, 2026
Primary completionEst.
Dec 1, 2027
CompletionEst.
Dec 1, 2028
Last update
May 13, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on May 13, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06995586
Lead sponsor
Nicosia General Hospital
Collaborators
University of Cyprus, AVVA Pharmaceuticals Ltd.
Responsible party
Athanasios Athanasiou (Cardiothoracic Surgeon (CTS), MD, MSc, MSc, MPA, PhD(cand.), Nicosia General Hospital) — Principal investigator
First posted
May 29, 2025
Start date
Sep 1, 2026 (estimated)
Primary completion
Dec 1, 2027 (estimated)
Completion
Dec 1, 2028 (estimated)
Last update
May 13, 2026

Study contacts

Athanasios D. Athanasiou, MD, MSc, MPA
Contact
drathanasiou@gmail.com
+357 99291629
Elpidoforos S. Soteriades, MD, Ass Prof
Contact
elpidoforos.soteriades@ouc.ac.cy
+357 22411956
Elpidoforos S. Soteriades, MD, Ass Prof
study chair · Open University of Cyprus
Athanasios D. Athanasiou, MD, MSc, MPA
principal investigator · Nicosia General Hospital
Elpidoforos S. Soteriades, MD, Ass Prof
study director · Open University of Cyprus

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in May 2026. You cannot join it, but the record below documents what was studied.

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Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

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Studies of the drugs tested here: Ascorbic Acid · Omega-3 fatty acid · Lactulose

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