title: Combination therapy of statin with flavonoids rich extract from chokeberry fruits enhanced reduction in cardiovascular risk markers in patients after myocardial infraction (MI).
abstract: Recent studies have shown, that chronic flavonoids treatment improves vascular function and cardiovascular remodeling by decreasing superoxide anion production as well as by increasing NO realize from endothelial cells. A progressive decrease in systolic blood pressure and reduction of low-density lipoprotein oxidation (Ox-LDL) has also been reported. However, none of these studies were done in patient with coronary artery disease treated with statins. This was a double-blind, placebo-controlled, parallel trial. Forty-four patients (11 women and 33 men, mean age 66 years) who survived myocardial infraction and have received statin therapy for at least 6 months (80% dose of 40 mg/day simvastatin) were included in the study. The subjects were randomised to receive either 3 x 85 mg/day of chokeberry flavonoid extract (Aronia melanocarpa E) or placebo for a period of 6 weeks. The study extract was a commercially-available (OTC) product of the following declared composition: anthocyans (about 25%), polymeric procyanidines (about 50%) and phenolic acids (about 9%). Compared to placebo (ANOVA and Tukey's test), flavonoids significantly reduced serum 8-isoprostans (p<0.000) and Ox-LDL levels (p<0.000) (by 38 and 29%, respectively), as well as hsCRP (p<0.007) and MCP-1 (p<0.001) levels (by 23 and 29%, respectively). In addition, significant increase in adiponectin (p<0.03) levels and reduction in systolic and diastolic blood pressure by a mean average of 11 and 7.2 mmHg, respectively were found.
  
  
  CONCLUSIONS
  In view of the fact that chokeberry flavonoids reduce the severity of inflammation, regardless of statins, they can be used clinically for secondary prevention of ischaemic heart disease.
authors.affiliation: Department of Pharmacognosy and Molecular Basis of Phythotherapy, Medical University of Warsaw, Ul. Banacha 1, Warszawa, Poland. marnar@farm.amwaw.edu.pl
authors.forename: Marek
authors.initials: M
authors.lastname: Naruszewicz
authors.forename: Iwona
authors.initials: I
authors.lastname: Laniewska
authors.forename: Barbara
authors.initials: B
authors.lastname: Millo
authors.forename: Mirosław
authors.initials: M
authors.lastname: Dłuzniewski
mesh_terms: D052242:Adiponectin / Q000097:blood; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects*; D002097:C-Reactive Protein / Q000187:drug effects; D015237:Dinoprost / Q000031:analogs & derivatives / Q000097:blood; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D010450:Endopeptidases / Q000187:drug effects; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007249:Inflammation / Q000188:drug therapy; D008077:Lipoproteins, LDL / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D017202:Myocardial Ischemia / Q000209:etiology / Q000517:prevention & control*; D046936:Photinia; D008517:Phytotherapy; D010936:Plant Extracts / Q000627:therapeutic use*
chemical_list: D052242:Adiponectin; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D010936:Plant Extracts; C099252:oxidized low density lipoprotein; C075750:8-epi-prostaglandin F2alpha; D002097:C-Reactive Protein; D015237:Dinoprost; D010450:Endopeptidases; C477696:protease MCP-01, Pseudoaltermonas