The thromboxane A2 pathway plays a major role in governing the reactions involved in both the inflammatory and hemostatic biological mechanisms. Cyclooxygenases 1 & 2 act to convert arachidonic acid to thromboxane A2. Scientific studies report cyclooxygenase-2 is up-regulated in many different chronic disease states as well as in chronic inflammation. This explains one major causes of residual thromboxane risk, “aspirin resistance.” Levels of urinary 11-dehydrothromboxane B2 reflect activity of components of the thromboxane A2 pathway that result n thromboxane A2 generation. The assay is normalized to the patient’s urine creatinine concentration and is non-invasive and normalized utilizing standard controls.

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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The cardiovascular effects of cocoa polyphenols-an overview

"Cocoa and cocoa polyphenols appear to exert promising cardioprotective effect in humans."

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Role of dietary polyphenols in the platelet aggregation network - a review of the in vitro studies

"Several epidemiological studies have reported a negative association between the intake of dietary polyphenols and the risk for cardiovascular disease (CVD).  Conversely, a certain number of studies have reported no association."

"The activity of dietary polyphenols on CVD has been attributed to both their antioxidant activity in preventing LDL oxidation, and to their effect on the pathogenesis of thrombosis by interfering with platelet activation and function.  In fact, platelets play an important role not only in the formation of actute thrombus and vessel occulsion, but also in the development of athersclerosis and CVD."

“The anti-aggregating effect depends in part on the specific structure of the phenol, even though great differences in anti-aggregating activity have been observed within each class.”

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Endogenous secretory RAGE in obese women: association with platelet activation and oxidative stress

"Excess adiposity may be implicated in RAGE hyperactivation and thromboxane-dependent platelet activation, contributing to obesity-related metabolic and vascular disease."

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Pentraxin 3 and platelet activation in obese patients after gastric banding

"High-sensitivity CRP decreased by 24 & 29.7% (P<0.0001), whereas CD40L decreased by 64.3 and 58.6% (P=0.002), respectively.  Urinary 11-dehydro-TxB2 decreased from 1,433 to 715 and 564 pg/mg creatinine, respectively, 6 months and 12 months after LAGB (P<0.0001). PTX3 was inversely related to platelet activation markers, 11-dehydro-TxB2 and CD40L.  Moreover, multiple regression analysis on pooled data showed that plasma PTX3 was an independent predictor of urinaty 11-dehydro-TxB2."

“There is an association between inflammation, platelet activation and metabolic dysfunction in obesity, and PTX3 is a key player within these circuits.”

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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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Adaptive regression modeling of biomarkers of potential harm in a population of U.S. adult cigarette smokers and nonsmokers

"This article describes the data mining analysis of a clinical exposure study of 3,585 adult smokers and 1077 nonsmokers.  The analysis focused on developing models for four biomarkers of potential harm:  white blood cell count (WBC), 24 h urine 8-ep-prostaglandin F2a, (EP18), 24 h urine 11-dehydro-thromboxane B2 (DEH11),  and high-density lipoprotein cholesterol (HDL)."

"Levels of WBC, EPI8, DEH11 and HDL were statistically associated with biomarkers of exposure to cigarette smoking and demographics and lifestyle factors."

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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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Platelet activation in obese Women. Role of inflammation and oxidant stress.

“Women with android obesity had higher levels of 8-iso PGF2alpha and 11-dehydro-TxB2 than nonobese women.” 

“Both 8-iso PGF2alpha and 11-dehydroTxB2 were higher in women with android obesity than women with gynoid obesity” 

“Of 20 women with android obesity, 11 achieved successful weight loss, which was associated with statistically significant reductions in C-reactive protein (median change 23%  p<.05), 8-iso PGF2alpha (median change 32%  p=.04) and 11-dehydro-TXB2 (median change 54% p=.005)." 

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