Madaj Paul M, Nelson JR, Li D, Ferdinand F and Budoff MJ
Introduction: Coronary Artery Disease (CAD) is one of the leading causes of morbidity and mortality in the world. Detection as well as modification of risk factors for cardiovascular disease (CVD) has been the topics research over several decades. Garlic has been noted to have a prominent role in the modification of risk factors including hypercholesteerolemia, hypertension and atherosclerosis. Garlic was found to have a role in reduction in SBP in those with elevated blood pressure, both central and peripheral. Previous studies have indicated a role for garlic in prevention of progression of atherosclerosis. Garlic has shown to have an inhibitory role in the progression of non-calcified coronary plaque. We sought to evaluate if the plaque progression properties of aged garlic extract (AGE) were related to remnant lipoproteins. Methods: Study population and randomization- The present study is a placebo-controlled double-blinded study. Seventy two patients were enrolled and underwent CCTA. The Investigational Review Board of Los Angeles Biomedical Research Institute at Harbor- UCLA approved this research project. All the patients signed informed written consent after careful explanation and review of protocol. Eligible participants were 40 to 75 years of age who had at least 2 components of the metabolic syndrome as defined by ATP III Clinical Identification of METs (including impaired fasting glucose >110 mg/dL, treated hypertension or systolic blood pressure >130 mmHg or diastolic blood pressure >85 mmHg, triglycerides >150 mg/dL, HDL cholesterol <35 mg/dL for men or <40 mg/dL for women, abdominal obesity defined by waist circumference >40 in for men or >35 in for women) . Glucose and cholesterol was assayed from serum using an Abbott autoanalyzer. Our participants all have a 10-years Framingham risk of coronary artery disease of 6-20%. Patients were assigned in 1:1 ratio to receive 2400 mg/day of AGE, or placebo. The intended duration of administration for the study group was 52 weeks. Results: Our results demonstrate baseline CAC 488.5 ± 723.2 in placebo group vs 168.4 ± 361.9 in garlic group (p-value 0.04). Follow up CAC results as follows: 577.9 ± 863.1 in placebo group vs 213.6 ± 470.6 in garlic group (p-value 0.05). The lipid profile results were not able to demonstrate statistically significant results. Conclusion: Our study was able to demonstrate a prominent role of garlic on CAC. We show that garlic does contribute and has a prominent role in the prevention and treatment of coronary artery disease. Despite our study not demonstrating a significant reduction in remnant lipoprotein along with triglycerides and inflammatory markers, other studies do demonstrate this link with garlic. Follow up studies are needed to evaluate the role of garlic on the various components of the atherosclerotic process.
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