title: Aged Garlic Extract Reduces Low Attenuation Plaque in Coronary Arteries of Patients with Metabolic Syndrome in a Prospective Randomized Double-Blind Study.
abstract: BACKGROUND
  Although several previous studies have demonstrated that aged garlic extract (AGE) inhibits the progression of coronary artery calcification, its effect on noncalcified plaque (NCP) has been unclear.
  
  
  OBJECTIVE
  This study investigated whether AGE reduces coronary plaque volume measured by cardiac computed tomography angiography (CCTA) in patients with metabolic syndrome (MetS).
  
  
  METHODS
  Fifty-five patients with MetS (mean ± SD age: 58.7 ± 6.7 y; 71% men) were prospectively assigned to consume 2400 mg AGE/d (27 patients) or placebo (28 patients) orally. Both groups underwent CCTA at baseline and follow-up 354 ± 41 d apart. Coronary plaque volume, including total plaque volume (TPV), dense calcium (DC), NCP, and low-attenuation plaque (LAP), were measured based upon predefined intensity cutoff values. Multivariable linear regression analysis, adjusted for age, gender, number of risk factors, hyperlipidemia medications, history of coronary artery disease, scan interval time, and baseline %TPV, was performed to examine whether AGE affected each plaque change.
  
  
  RESULTS
  The %LAP change was significantly reduced in the AGE group compared with the placebo group (-1.5% ± 2.3% compared with 0.2% ± 2.0%, P = 0.0049). In contrast, no difference was observed in %TPV change (0.3% ± 3.3% compared with 1.6% ± 3.0%, P = 0.13), %NCP change (0.2% ± 3.3% compared with 1.4% ± 2.9%, P = 0.14), and %DC change (0.2% ± 1.4%, compared with 0.2% ± 1.7%, P = 0.99). Multivariable linear regression analysis found a beneficial effect of AGE on %LAP regression (β: -1.61; 95% CI: -2.79, -0.43; P = 0.008).
  
  
  CONCLUSIONS
  This study indicates that the %LAP change was significantly greater in the AGE group than in the placebo group. Further studies are needed to evaluate whether AGE has the ability to stabilize vulnerable plaque and decrease adverse cardiovascular events. This trial was registered at clinicaltrials.gov as NCT01534910.
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Suguru
authors.initials: S
authors.lastname: Matsumoto
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Rine
authors.initials: R
authors.lastname: Nakanishi
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Dong
authors.initials: D
authors.lastname: Li
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Anas
authors.initials: A
authors.lastname: Alani
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Panteha
authors.initials: P
authors.lastname: Rezaeian
authors.affiliation: Mercy Medical Center, Merced, CA;
authors.forename: Sach
authors.initials: S
authors.lastname: Prabhu
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Jeby
authors.initials: J
authors.lastname: Abraham
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Michael A
authors.initials: MA
authors.lastname: Fahmy
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Christopher
authors.initials: C
authors.lastname: Dailing
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Flores
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA;
authors.forename: Sajad
authors.initials: S
authors.lastname: Hamal
authors.affiliation: Leiden University Medical Center, Leiden, Netherlands; and.
authors.forename: Alexander
authors.initials: A
authors.lastname: Broersen
authors.affiliation: Leiden University Medical Center, Leiden, Netherlands; and Medis Medical Imaging Systems, Leiden, Netherlands.
authors.forename: Pieter H
authors.initials: PH
authors.lastname: Kitslaar
authors.affiliation: Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, CA; mbudoff@labiomed.org.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Budoff
mesh_terms: D002118:Calcium / Q000378:metabolism; D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000187:drug effects* / Q000473:pathology; D018450:Disease Progression; D004311:Double-Blind Method; D005260:Female; D005737:Garlic; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D058226:Plaque, Atherosclerotic / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D010936:Plant Extracts; D002118:Calcium
keywords: atherosclerosis; cardiac ct; garlic; progression; randomized trial