Beneficial Effects of Grape Resveratrol on Serum Adiponectin and Inflammation: Clinical Trial in Patients with Stable Coronary Artery Disease

Abstract

Coronary artery disease (CAD) is a leading cause of heart failure on a world-wide basis [1–3]. The epidemic proportion of CAD is increasing worldwide irrespective of gender [3, 4]. Coronary artery disease is associated with lower oxygen supply and demand ratio due to abnormalities of the coronary vasculature. The coronary arteries supply oxygenated blood to the heart muscle and due to the process of atherosclerosis leading to plaque rupture and acute coronary syndrome, myocardial blood supply is compromised leading to myocardial ischemia/infarction and heart failure [5, 6]. Many clinicians and cardiovascular researchers recognize the clinical as well as molecular pathophysiological basis of coronary artery disease. There are many research groups actively searching the intervention strategies to prevent CAD. Many of these studies confirmed that CAD can be favorably prevented by lifestyle modifications (dietary control, exercise and smoking cessation) and pharmacotherapy [7]. However current pharmacotherapies which include anti-platelet drugs (aspirin, clopidogrel and prasugrel), betablockers, statin therapy and ACE inhibitors, are suboptimal [8, 9]. Resveratrol is a polyphenolic flavonoid with phytoalexin properties and has several pleotropic effects on cardiovascular function such as anti-oxidant and antiinflammatory effects and metabolic modulation (Fig. 1) [10–14]. However, these studies were performed in animal models and clinical evidence of the therapeutic effectiveness of resveratrol in humans is limited. In this issue of Cardiovascular Drugs and Therapy, Tome-Carneiro et al. investigate and analyze the beneficial pleotropic effects of 1 year dietary intervention with resveratrol containing grape extract (U.V treated grapes) on inflammatory as well as fibrinolytic status in patients with stable coronary artery disease [15]. Naturally the content of resveratrol in dietary sources is very low and the consumption of these natural food items (wine and grapes) does not exert beneficial effects in the prevention of many cardiovascular complications. As such Tome-Carneiro et al. used a novel resveratrol rich grape extract (GE-RES) obtained from U.V treated grapes (GE-RSE) in dietary intervention of CAD patents. Resveratrol is a potent therapeutical phytochemical with cardioprotective effects [10]. It targets and modulates pathological death signals and can protect patients by preventing several cardiovascular risk factors from causing endothelial dysfunction, inflammation, atherosclerotic plaque formation and dyslipidemia [1]. Inflammation and atherogenesis are the initial manifestations in coronary artery disease, which is associated with focal S. K. Das :V. B. Patel :G. Y. Oudit Division of Cardiology, Department of Medicine, University of Alberta, Edmonton, Canada