Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study
| Autor: | Astrid Hirt, Thomas F. Lüscher, Priska Kaiser, Daniel Périat, Klaus Uhlenhut, Frank Enseleit, Michel Neidhart, Frank Ruschitzka, Georg Noll, Mathias Wolfrum, Petra Högger, Christian M. Matter, Isabella Sudano, Stephan Winnik, Nazmi Krasniqi, Georg M. Fröhlich, Sarah R. Haile, Andreas J. Flammer |
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| Přispěvatelé: | University of Zurich, Enseleit, Frank |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Male
Vasodilator Agents Anti-Inflammatory Agents Blood Pressure Coronary Artery Disease 030204 cardiovascular system & hematology Gastroenterology Antioxidants Coronary artery disease 0302 clinical medicine Medicine Prospective Studies 030212 general & internal medicine Endothelial dysfunction Brachial artery Prospective cohort study Cross-Over Studies Endothelin-1 10051 Rheumatology Clinic and Institute of Physical Medicine Middle Aged 3. Good health Vasodilation C-Reactive Protein Treatment Outcome medicine.anatomical_structure 10209 Clinic for Cardiology Female Shear Strength Cardiology and Cardiovascular Medicine Adult Blood Platelets medicine.medical_specialty Endothelium 610 Medicine & health Arginine Placebo 2705 Cardiology and Cardiovascular Medicine 03 medical and health sciences Double-Blind Method medicine.artery Internal medicine Humans Antihypertensive Agents Aged Flavonoids Plant Extracts business.industry 10060 Epidemiology Biostatistics and Prevention Institute (EBPI) medicine.disease Crossover study Surgery Oxidative Stress Blood pressure Endothelium Vascular business Biomarkers |
| Zdroj: | European heart journal |
| ISSN: | 0064-1758 |
| Popis: | Aims Extracts from pine tree bark containing a variety of flavonoids have been used in traditional medicine. Pycnogenol is a proprietary bark extract of the French maritime pine tree (Pinus pinaster ssp. atlantica) that exerts antioxidative, anti-inflammatory, and anti-platelet effects. However, the effects of Pycnogenol on endothelial dysfunction, a precursor of atherosclerosis and cardiovascular events, remain still elusive. Methods and results Twenty-three patients with coronary artery disease (CAD) completed this randomized, double-blind, placebo-controlled cross-over study. Patients received Pycnogenol (200 mg/day) for 8 weeks followed by placebo or vice versa on top of standard cardiovascular therapy. Between the two treatment periods, a 2-week washout period was scheduled. At baseline and after each treatment period, endothelial function, non-invasively assessed by flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound, biomarkers of oxidative stress and inflammation, platelet adhesion, and 24 h blood pressure monitoring were evaluated. In CAD patients, Pycnogenol treatment was associated with an improvement of FMD from 5.3 ± 2.6 to 7.0 ± 3.1 (P < 0.0001), while no change was observed with placebo (5.4 ± 2.4 to 4.7 ± 2.0; P = 0.051). This difference between study groups was significant [estimated treatment effect 2.75; 95% confidence interval (CI): 1.75, 3.75, P < 0.0001]. 15-F2t-Isoprostane, an index of oxidative stress, significantly decreased from 0.71 ± 0.09 to 0.66 ± 0.13 after Pycnogenol treatment, while no change was observed in the placebo group (mean difference 0.06 pg/mL with an associated 95% CI (0.01, 0.11), P = 0.012]. Inflammation markers, platelet adhesion, and blood pressure did not change after treatment with Pycnogenol or placebo. Conclusion This study provides the first evidence that the antioxidant Pycnogenol improves endothelial function in patients with CAD by reducing oxidative stress. Clinical Trial Registration: ClinicalTrials.gov identifier: NCT00641758 |
| Databáze: | OpenAIRE |
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