Aged garlic extract improves endothelial function in men with coronary artery disease

Abstract

Endothelium-dependent vasodilation is impaired and predicts the risk of a coronary event in patients with coronary artery disease (CAD). Oxidant stress and increased systemic inflammation may contribute to this endothelial dysfunction. Aged garlic extract (AGE) contains antioxidant compounds and increases nitric oxide production and decreases the output of inflammatory cytokines from cultured cells. The aim of this study was to test the effect of treatment with AGE on brachial artery flow mediated endothelium-dependent dilation (FMD) and circulating markers of oxidative stress and systemic inflammation. The trial included 15 men with angiographically proven CAD in a randomized, placebo-controlled, cross-over design with 2-week treatment and washout periods. During AGE supplementation, FMD increased (44%) significantly (p = 0.04) from the baseline and mainly in men with lower baseline FMD. Levels of FMD at the end of AGE treatment were significantly (p = 0.03) higher compared with the corresponding levels at the end of placebo treatment when the variation in baseline body weight was taken into account. Markers of oxidant stress (plasma oxidized low density lipoprotein and peroxides), systemic inflammation (plasma C-reactive protein ad interleukin-6) and endothelial activation (VCAM-1) did not change significantly during the study. These data suggest that short-term treatment with AGE may improve impaired endothelial function in men with CAD treated with aspirin and a statin. Whether improvement in endothelial function decreases the risk of future cardiovascular events remains to be determined.

A Systematic Review of the Efficacy of Bioactive Compounds in Cardiovascular Disease: Carbohydrates, Active Lipids and Nitrogen Compounds

“…The main outcomes of these studies consisted of BP, lipids profile, endothelial function, oxidative stress, inflammatory biomarkers, and coronary artery calcification (CAC), platelet aggregation and adhesion just as changes in 10 years prognostic risk of myocardial infarction and sudden death. Within lipids profile measured by the two interventions [38,39,40], LDLc and TC parameters were significantly decreased after allicor treatments [39]. Reduction of CAC progression was detected in the study that assessed it [38] (table 3).…”

“…Sobenin et al [39] observed a decrease in multifunctional prognostic risk of myocardial infarction and sudden death prevents the rise of risk with aging. Williams et al [40] only reported significant changes in the endothelial function. Ried et al [41] also assessed the effect of AGE in capsules (960 mg/day containing 2.4 mg S-allylcysteine), as well as of different doses (240/480/960 mg/day (0.6/1.2/2.4 mg/day of S-allylcysteine)) [42] as an adjuvant to antihypertensive medication in patients with uncontrolled hypertension, both during 12 weeks.…”

“…Three clinical trials were related to coronary artery disease (CAD) patients: the effect of 4 ml/day of AGE was evaluated in 23 subjects [38], while Sobenin et al [39] investigated the effect of allicor (garlic powder) in 51 subjects, both during a period of one year. However, Williams et al [40] assessed 2.4 g/day of AGE only during two weeks. The main outcomes of these studies consisted of BP, lipids profile, endothelial function, oxidative stress, inflammatory biomarkers, and coronary artery calcification (CAC), platelet aggregation and adhesion just as changes in 10 years prognostic risk of myocardial infarction and sudden death.…”

“…We must also take into account the decrease of the CAC progression rate [38], which is an excellent marker of overall coronary atherosclerotic burden correlating with both the total plaque burden and the presence of obstructive disease [63]. With reference to Williams et al [40], we must consider that the evaluation of AGE was only during two weeks, and this period is short to consider the changes. Even so, endothelial function improved after such intervention.…”

Nitric Oxide-Mediated Coronary Flow Regulation in Patients with Coronary Artery Disease: Recent Advances

“…112 Intravenous administration of Ginkgo biloba extract to patients with CAD increased LAD coronary artery blood flow and brachial artery flow-dependent dilatation. 113 In addition, plasma NO increased and ET-1 decreased after 2 weeks of ginkgo extract treatment; a linear correlation was obtained between the percentage change in LAD coronary artery blood flow and in NO, ET-1, or NO/ ET-1 ratio following extract treatment, suggesting that the ginkgo extract led to an increase in coronary blood flow, which may be related to improvement of NO/ET-1 imbalance.…”