Objectives Antioxidants can reduce oxidative radicals that affect the early phase of atherogenesis, that is endothelial dysfunction. Polysaccharide Peptide (PsP) derived from Ganoderma lucidum has an active substance in the form of β-glucan. Previous studies have proven the PsP of Ganoderma lucidum as an effective antioxidant in atherosclerotic rats and shows no toxicity in animal model. This study aims to prove the effect of PsP as potent antioxidant in high risk and stable angina patients. Method This is a clinical trial conducted to 37 high risk and 34 stable angina patients, which were determined based on ESC Stable CAD Guidelines and Framingham risk score, with pre and post test design without control group. The parameters are superoxide dimustase (SOD) and malondialdehyde (MDA) concentration, circulating endothelial cell (CEC) and endothelial progenitor cell (EPC) counts. The patients were given PsP 750 mg/day in 3 divided dose for 90 days. Paired t -test was performed for normally distributed data, and Wilcoxon test for not normally distributed data, and significant level of p ≤ 0,05. Results SOD level in high risk patients slightly increased but not statistically significant with p = 0,22. Level of SOD in stable angina group significantly increased with p = 0,001. MDA concentration significantly reduced in high risk and stable angina patients with p = 0.000. CEC significantly reduced both in high risk and stable angina patients, with p = 0.000 in both groups. EPC count significantly reduced in high risk and stable angina with p = 0.000. Conclusion PsP of Ganoderma lucidum is a potent antioxidant against pathogenesis of atherosclerosis in stable angina and high risk patients

This study aims to prove the effect of the polysaccharide peptide (PsP) of Ganoderma lucidum to reduce endothelial injury and improve endothelial function. Material and methods:This is a clinical trial with pre-post-test design, conducted in 40 high-risk and 40 stable angina patients, determined based on the 2016 European Society of Cardiology guideline for stable coronary artery disease.Stable angina and high risk patients were given PsP 750 mg/day in three divided doses for 90 days in addition to their regular medications, given by their cardiologist. Informed consent was obtained and ethical clearance was published. Endothelial injury was measured with circulating endothelial cells (CEC) count using flow cytometry, and endothelial regeneration, measured with the endothelial progenitor cells (EPC) count using flow cytometry. Non-adherence of >80% was considered to be drop-out case.Results: During follow-up, nine patients were considered to drop-out because of non-adherence. No significant adverse effects were documented.CEC significantly reduced both in high-risk and stable angina patients, with the average count of CEC reduced from 7.91 to 1.76 cells/ml in stable angina patients, and from 7.38 to 2.23 cells/ml in high-risk patients (p=0.001). EPC count significantly reduced in high-risk and stable angina with p=0,000, with average count of 15.11 cells/ml reduced to 6.14 cells/ml in stable angina and 12.94 to 6.10 cells/ml in the high-risk group. Conclusion:PsP of G lucidum could reduce endothelial injury significantly, but the following reduction of EPC needs further research whether because of the minimal endothelial injury that was not enough to induce EPC mobilisation.

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