title: Dark chocolate improves coronary vasomotion and reduces platelet reactivity.
abstract: BACKGROUND
  Dark chocolate has potent antioxidant properties. Coronary atherosclerosis is promoted by impaired endothelial function and increased platelet activation. Traditional risk factors, high oxidative stress, and reduced antioxidant defenses play a crucial role in the pathogenesis of atherosclerosis, particularly in transplanted hearts. Thus, flavonoid-rich dark chocolate holds the potential to have a beneficial impact on graft atherosclerosis.
  
  
  RESULTS
  We assessed the effect of flavonoid-rich dark chocolate compared with cocoa-free control chocolate on coronary vascular and platelet function in 22 heart transplant recipients in a double-blind, randomized study. Coronary vasomotion was assessed with quantitative coronary angiography and cold pressor testing before and 2 hours after ingestion of 40 g of dark (70% cocoa) chocolate or control chocolate, respectively. Two hours after ingestion of flavonoid-rich dark chocolate, coronary artery diameter was increased significantly (from 2.36+/-0.51 to 2.51+/-0.59 mm, P<0.01), whereas it remained unchanged after control chocolate. Endothelium-dependent coronary vasomotion improved significantly after dark chocolate (4.5+/-11.4% versus -4.3+/-11.7% in the placebo group, P=0.01). Platelet adhesion decreased from 4.9+/-1.1% to 3.8+/-0.8% (P=0.04) in the dark chocolate group but remained unchanged in the control group.
  
  
  CONCLUSIONS
  Dark chocolate induces coronary vasodilation, improves coronary vascular function, and decreases platelet adhesion 2 hours after consumption. These immediate beneficial effects were paralleled by a significant reduction of serum oxidative stress and were positively correlated with changes in serum epicatechin concentration.
authors.affiliation: Cardiovascular Center, Cardiology, University Hospital Zurich, Raemistr 100, CH-8091 Zurich, Switzerland.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Flammer
authors.forename: Frank
authors.initials: F
authors.lastname: Hermann
authors.forename: Isabella
authors.initials: I
authors.lastname: Sudano
authors.forename: Lukas
authors.initials: L
authors.lastname: Spieker
authors.forename: Matthias
authors.initials: M
authors.lastname: Hermann
authors.forename: Karen A
authors.initials: KA
authors.lastname: Cooper
authors.forename: Mauro
authors.initials: M
authors.lastname: Serafini
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Frank
authors.initials: F
authors.lastname: Ruschitzka
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
mesh_terms: D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D002099:Cacao; D002182:Candy; D017023:Coronary Angiography / Q000379:methods; D003331:Coronary Vessels / Q000187:drug effects* / Q000502:physiology; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005419:Flavonoids / Q000008:administration & dosage; D016027:Heart Transplantation / Q000379:methods; D006801:Humans; D010973:Platelet Adhesiveness / Q000187:drug effects* / Q000502:physiology; D014664:Vasodilation / Q000187:drug effects* / Q000502:physiology; D014666:Vasomotor System / Q000187:drug effects / Q000503:physiopathology
chemical_list: D005419:Flavonoids