Effects of Pycnogenol on endothelial function in patients with stable coronary artery disease: a double-blind, randomized, placebo-controlled, cross-over study.

Abstract

AIMS:

Extracts from pine tree bark containing a variety of flavonoids have been used in traditional medicine. Pycnogenol is a proprietary bark extract of the French maritime pine tree (Pinus pinaster ssp. atlantica) that exerts antioxidative, anti-inflammatory, and anti-platelet effects. However, the effects of Pycnogenol on endothelial dysfunction, a precursor of atherosclerosis and cardiovascular events, remain still elusive.

METHODS AND RESULTS:

Twenty-three patients with coronary artery disease (CAD) completed this randomized, double-blind, placebo-controlled cross-over study. Patients received Pycnogenol (200 mg/day) for 8 weeks followed by placebo or vice versa on top of standard cardiovascular therapy. Between the two treatment periods, a 2-week washout period was scheduled. At baseline and after each treatment period, endothelial function, non-invasively assessed by flow-mediated dilatation (FMD) of the brachial artery using high-resolution ultrasound, biomarkers of oxidative stress and inflammation, platelet adhesion, and 24 h blood pressure monitoring were evaluated. In CAD patients, Pycnogenol treatment was associated with an improvement of FMD from 5.3 ± 2.6 to 7.0 ± 3.1 (P < 0.0001), while no change was observed with placebo (5.4 ± 2.4 to 4.7 ± 2.0; P = 0.051). This difference between study groups was significant [estimated treatment effect 2.75; 95% confidence interval (CI): 1.75, 3.75, P < 0.0001]. 15-F(2t)-Isoprostane, an index of oxidative stress, significantly decreased from 0.71 ± 0.09 to 0.66 ± 0.13 after Pycnogenol treatment, while no change was observed in the placebo group (mean difference 0.06 pg/mL with an associated 95% CI (0.01, 0.11), P = 0.012]. Inflammation markers, platelet adhesion, and blood pressure did not change after treatment with Pycnogenol or placebo.

CONCLUSION:

This study provides the first evidence that the antioxidant Pycnogenol improves endothelial function in patients with CAD by reducing oxidative stress.

• Authors: Frank Enseleit, Isabella Sudano, Daniel Périat, Stephan Winnik, Mathias Wolfrum, Andreas J Flammer, Georg M Fröhlich, Priska Kaiser, Astrid Hirt, Sarah R Haile, Nazmi Krasniqi, Christian M Matter, Klaus Uhlenhut, Petra Högger, Michel Neidhart, Thomas F Lüscher, Frank Ruschitzka, Georg Noll
• Journal: European heart journal (Eur Heart J) Vol. 33 Issue 13 Pg. 1589-97 (Jul 2012) ISSN: 1522-9645 [Electronic] England
• PMID: 22240497 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Antihypertensive Agents
• Antioxidants
• Biomarkers
• Endothelin-1
• Flavonoids
• Plant Extracts
• Vasodilator Agents
• dimethylarginine
• pycnogenols
• C-Reactive Protein
• Arginine

Topics

• Adult
• Aged
• Anti-Inflammatory Agents (administration & dosage)
• Antihypertensive Agents (administration & dosage)
• Antioxidants (administration & dosage)
• Arginine (analogs & derivatives, metabolism)
• Biomarkers (metabolism)
• Blood Platelets (drug effects)
• Blood Pressure (drug effects)
• C-Reactive Protein (metabolism)
• Coronary Artery Disease (drug therapy, physiopathology)
• Cross-Over Studies
• Double-Blind Method
• Endothelin-1 (drug effects)
• Endothelium, Vascular (drug effects)
• Female
• Flavonoids (administration & dosage)
• Humans
• Male
• Middle Aged
• Oxidative Stress (drug effects)
• Plant Extracts
• Prospective Studies
• Shear Strength
• Treatment Outcome
• Vasodilation (drug effects)
• Vasodilator Agents (administration & dosage)