Abstract
Coronary artery disease is the leading cause of mortality and morbidity worldwide. The pathogenesis is mainly due to atherosclerosis, plaque rupture, and platelet thrombus formation. The main risk factors for coronary artery disease include obesity, hypercholesterolemia, smoking, diabetes, and high blood pressure. As a part of disease management, treatment options using anticoagulant and antiplatelet drugs can be applied with addition to lipid-lowering medication. However, medicinal plants comprising antiatherothrombotic effects can be used as options to combat the disease rather than drug therapies with lesser adverse effects. Therefore, the haematological effect of Berberis vulgaris L., Teucrium polium L., and Orthosiphon stamineus Benth extracts was studied using in vitro model to prevent and to treat coronary atherothrombotic disease. The aqueous, methanol, and polysaccharide extracts of B. vulgaris, T. polium, and O. stamineus, respectively, were studied for their anticoagulant and antiplatelet effect on human whole blood. Extracts were subjected to the prothrombin time (PT) and activated partial thromboplastin time (APTT) test for anticoagulant activity. The antiplatelet activity was investigated using an electrical impedance method. B. vulgaris aqueous extract (BVAE), B. vulgaris polysaccharide extract (BVPE), T. polium aqueous extract (TPAE), and T. polium polysaccharide extract (TPPE) significantly prolonged the coagulation time in a concentration-dependent manner (p<0.05). The administration of BVAE demonstrated the most effective antiplatelet activity against platelet aggregation caused by arachidonic acid (AA) and collagen. These antiplatelet activities may correspond to the presence of higher total phenolic compound, which thus inhibit the platelet aggregation activity. In conclusion, these findings provide strong evidence on the antiatherothrombotic effect of BVAE and TPAE.
Highlights
The World Health Organization reported that coronary artery disease (CAD) is the leading cause of death and disability in the world [1]
Three plants were used in this study, namely, B. vulgaris (BV), T. polium (TP), and O. stamineus (OS)
A one-way analysis of variance (ANOVA) was performed to compare the effect of prothrombin time (PT) and activated partial thromboplastin time (APTT) between groups of extracts followed by LSD post hoc test
Summary
The World Health Organization reported that coronary artery disease (CAD) is the leading cause of death and disability in the world [1]. It is estimated that about 17.3 million people died from CAD in 2008, and, by 2030, approximately 23.6 million of global mortality will be from this disease [2]. The risk factor for CADs is mainly due to atherosclerosis which leads to arterial thrombosis. The pathogenesis of atherothrombosis started with endothelial disturbance by many noxious stimuli, including oxidised LDL cholesterol, glycation end-products, smoking, and hypertension. The endothelial disturbance could lead to inflammation, oxidation of more lipoproteins, smooth muscle cell proliferation, platelet activation, hypercoagulation, and thrombosis formation. Hypercholesterolemia with high LDL increases the release of platelet-activating factor, which in turn increases the production of inflammatory
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