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Cardiovascular Disease

The thromboxane A2 pathway and its components are implicated in the progression of atherosclerosis and cardiovascular diseases. (CAD) Thromboxane A2 is clearly involved in CAD due to its acute and chronic role in promotion of vasoconstriction and platelet aggregation. The success of low-dose aspirin in prevention of CAD is explained by platelet COX-1 inhibiting thromboxane A2 biosynthesis. Levels of urinary 11-dehydrothromboxane B2 reflect activity of components of the thromboxane A2 pathway that regulate thromboxane A2 generation.

Urinary 11-dehydro-thromboxane B2 as a predictor of acute myocardial infarction outcomes: results of leukotriene and thromboxane in myocardial infarction (LTMI) study

"Urinary 11-dehydro-thromboxane (TX)B2 has been described as a potential predictive biomarker of major adverse cardiovascular events (MACEs) in high cardiac risk patients.”

“11-Dehydro-TXB2 predicts 1-year cumulative MACEs in AMI patients and provides prognostic information on the left ventricular performance."

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The Current and Future Landscape of Urinary Thromboxane Testing to Evaluate Atherothrombotic Risk


"Biomarker testing for efficacy of therapy is an accepted way for clinicians to individualize dosing to genetic and/or environmental factors that may be influencing a treatment regimen.  Aspirin is used by nearly 43 million Americans on a regular basis to reduce risks associated with various artherothrombotic diseases.  Despite its widespread use, many clinicians are unaware of the link between suboptimal response to aspirin therapy and increased risk for inferior clinical outcomes in several disease states, and biomarker testing for efficacy of aspirin therapy is not performed as routinely as efficacy testing in other therapeutic areas.  This article reviews the clinical and laboratory aspects of determining whole-body thromboxane production, particularly as it pertains to efficacy assessment of aspirin responsiveness."

"Aspirin use has been shown to cause a dose-dependent reduction in urinary levels of 11-dehydroTxB2."

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Prostaglandins & Other Lipid Mediators

"Urinary 11-dehydro-thromboxane B2 levels are associated with vascular inflammation and prognosis in atherosclerotic cardiovascular disease."

"Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide despite recent advances in its management and treatment. Inflammation is a key driver of the pathogenesis and progression of ASCVD in preclinical models and humans." 

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A Japanese cross-sectional multicenter study of biomarkers associated with cardiovascular disease in smokers and non-smokers

“The mean hs-CRP concentration was not significantly different between the two groups of subjects.”

“We found that the 11-DTXB2 concentration was about 24% greater in smokers than in non-smokers, supporting the use of 11-DTXB2 as a potential biomarker for smoking and CVD.”

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Molecular targets of tea polyphenols in the cardiovascular system

"Tea-derived polyphenols have attracted considerable attention in the prevention of cancer and cardiovascular diseases.  In comparison to tumour cells, the elucidation of their molecular targets in cardiovascular relevant cells is still at the beginning.  Although promising, experimental and clinical data demonstrate protective effects for the cardiovasclar system, little information is actually available on how these beneficial effects of tea polyphenols are mediated at the cellular level.  By affecting the activity of receptor and signal transduction kinases, both catechins and theaflavins - the major ingredients of green and black tea, respectively - exert a variety of cardiovascular beneficial effects."

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Natural sources of resveratrol and mechanisms of action with emphasis on cardiovascular disease: a brief review

“Epidemiological studies indicate that the consumption of red wine reduces the mortality and morbidity from CAD. Muscadine grapes contain high levels of antioxidants, including resveratrol, a polyphenol with multiple cardioprotective effects.” 

"These antioxidants are thought to be the effective agents behind the so-called "French Paradox," the low mortality rate from CAD amongs the French population desipite their high-fat diet and smoking."

"Resveratrol has been shown to inhibit lipid peroxidation of LDL, prevent the cytoxicity of oxidized LDL, protect cells against lipid peroxidation, reduce platelet aggregation, and inhibit vascular SMC proliferation".

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The cardiovascular benefits of dark chocolate

"Dark chocolate contains many biologically active components, such as catechins, procyanidins, and theobromine from cocoa, together with added sucrose and lipids.  All of these can directly or indirectly affect the cardiovascular system by multiple mechanisms."

"The effect of chocolate is more convoluted since the sucrose and lipid may transiently and negatively impact on endothelial function, partly through insulin signaling and nitric oxide bioavailability."

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Olive oil and hemostasis: a review on its healthy effects

"Interest in the Mediterranean diet (MD) has grown worldwide in the course of the past decade, even among nutritionists outside of the Mediterranean area.  This is largely due to the fact that the consumption of the MD has been linked to greater longevity, improved quality of life and lower incidences of cardiovascular disease, cancer and age cognitive decline, in spite of being a dietary model with a high fat content, unlike the diets recommended for several decades by many experts in nutrition in other geographical areas."  

“A diet enriched in virgin olive oil can reduce the sensitivity of platelets to aggregation, decreasing von Willebrand and thromboxane B2 plasma levels."

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Opposite effects of nicotinic acid and pyridoxine on systemic prostacyclin, thromboxane and leukotriene production in man

"The results of this study suggest that nicotinic acid increases thromboxane and leukotriene synthesis which may not be beneficial for patients with cardiovascular diseases or asthma.  In contrast, the increase of prostacyclin production and the inhibition in thromboxane and leukotriene synthesis by pyriodoxine might be beneficial in disorders where the production of prostacyclin is decreased and the formation of thromboxane and cysteinyl leukotrienes is enhanced.

"The treatment with nicotinic acid increased 11-DHTXB2 excretion to 2.6 fold and leukotriene E4 excretion to twice the basal values."

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Risk factors for carotid atherosclerosis and platelet activation

"In the 24 patients in whom the plaque score was measured, multivariate analysis indicated a significant positive correlation between urinary excretion of 11-dehydrothromboxane B2 and plaque score, age, smoking and hypercholestermia.  Our results indicate the risk factors such as age, hypercholestermia, atherosclerosis and smoking activate platelets in vivo to develop carotid atherosclerosis."

"Multivariate analysis indicated a significant positive correlation between urinary excretion of 11-dehydrothromboxane B2 and plaque score, age, smoking and hypercholesteremia."

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