Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial

<b>Background:</b> Inflammation plays a critical role in the progression of coronary heart disease (CHD). Low-dose colchicine has shown promise in reducing cardiovascular events, and green Brazilian propolis extract (EPP-AF® (standardized Brazilian green propolis extract) was provided by...

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Main Authors: Clara Salles Figueiredo, Luiz Carlos Santana Passos, Caio Rebouças Fonseca Cafezeiro, Rodrigo Morel Vieira de Melo, Tainá Teixeira Viana, Eduardo Jorge Gomes de Oliveira, Andresa Aparecida Berretta, Marcelo Augusto Duarte Silveira
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Language:English
Published: MDPI AG 2025-05-01
Series:Pharmaceuticals
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Online Access:https://www.mdpi.com/1424-8247/18/6/827
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author Clara Salles Figueiredo
Luiz Carlos Santana Passos
Caio Rebouças Fonseca Cafezeiro
Rodrigo Morel Vieira de Melo
Tainá Teixeira Viana
Eduardo Jorge Gomes de Oliveira
Andresa Aparecida Berretta
Marcelo Augusto Duarte Silveira
author_facet Clara Salles Figueiredo
Luiz Carlos Santana Passos
Caio Rebouças Fonseca Cafezeiro
Rodrigo Morel Vieira de Melo
Tainá Teixeira Viana
Eduardo Jorge Gomes de Oliveira
Andresa Aparecida Berretta
Marcelo Augusto Duarte Silveira
author_sort Clara Salles Figueiredo
collection DOAJ
description <b>Background:</b> Inflammation plays a critical role in the progression of coronary heart disease (CHD). Low-dose colchicine has shown promise in reducing cardiovascular events, and green Brazilian propolis extract (EPP-AF® (standardized Brazilian green propolis extract) was provided by Apis Flora Indl. Coml. Ltda, Ribeirão Preto, SP, Brazil), known for its anti-inflammatory properties, may offer additional therapeutic benefits. This pilot study aimed to evaluate whether six weeks of EPP-AF<sup>®</sup> supplementation improves functional capacity assessed by treadmill exercise testing. <b>Methods</b>: This was a randomized, double-blind, placebo-controlled pilot study conducted at a coronary disease clinic in Brazil. Patients aged ≥ 18 years with stable CHD receiving optimized medical therapy were randomized in a 2:1 ratio to receive either 200 mg of EPP-AF<sup>®</sup> or placebo twice daily for six weeks. The primary outcome was the change in treadmill exercise duration (in seconds). Secondary outcomes included total exercise time, functional capacity (measured in metabolic equivalents of task [METs]), high-sensitivity C-reactive protein (hs-CRP) levels, the Seattle Angina Questionnaire (SAQ), and the Canadian Cardiovascular Society (CCS) angina classification. Statistical analysis was performed on an intention-to-treat basis. <b>Results</b>: A total of 59 patients were randomized, with a median follow-up of 6.5 weeks. There was no significant difference in the primary endpoint between groups: the median change in treadmill test time was 39 s in the EPP-AF<sup>®</sup> group versus 30 s in the placebo group (<i>p</i> = 0.83). No improvements were observed in METs, hs-CRP levels, SAQ scores, or CCS class in the EPP-AF<sup>®</sup> group. No major adverse cardiovascular events occurred during the study. <b>Conclusions:</b> EPP-AF<sup>®</sup> did not improve functional capacity, inflammatory markers, or angina symptoms in patients with stable CHD compared to placebo.
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spelling doaj-art-9152da62604c43f99d9af331c8365c782025-08-20T03:16:35ZengMDPI AGPharmaceuticals1424-82472025-05-0118682710.3390/ph18060827Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized TrialClara Salles Figueiredo0Luiz Carlos Santana Passos1Caio Rebouças Fonseca Cafezeiro2Rodrigo Morel Vieira de Melo3Tainá Teixeira Viana4Eduardo Jorge Gomes de Oliveira5Andresa Aparecida Berretta6Marcelo Augusto Duarte Silveira7Programa de Pós-Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, BrazilPrograma de Pós-Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, BrazilHospital Ana Nery, Salvador 40301-155, BA, BrazilPrograma de Pós-Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, BrazilPrograma de Pós-Graduação em Medicina e Saúde (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, BrazilHospital Ana Nery, Salvador 40301-155, BA, BrazilDevelopment and Innovation Department, Apis Flora Indl. Coml. Ltd., Rua Triunfo 945, Subsetor Sul 3, Ribeirão Preto 14020-670, SP, BrazilD’Or Institute for Research and Education (IDOR), Hospital São Rafael, Avenida São Rafael 2152, São Marcos, Salvador 41253-190, BA, Brazil<b>Background:</b> Inflammation plays a critical role in the progression of coronary heart disease (CHD). Low-dose colchicine has shown promise in reducing cardiovascular events, and green Brazilian propolis extract (EPP-AF® (standardized Brazilian green propolis extract) was provided by Apis Flora Indl. Coml. Ltda, Ribeirão Preto, SP, Brazil), known for its anti-inflammatory properties, may offer additional therapeutic benefits. This pilot study aimed to evaluate whether six weeks of EPP-AF<sup>®</sup> supplementation improves functional capacity assessed by treadmill exercise testing. <b>Methods</b>: This was a randomized, double-blind, placebo-controlled pilot study conducted at a coronary disease clinic in Brazil. Patients aged ≥ 18 years with stable CHD receiving optimized medical therapy were randomized in a 2:1 ratio to receive either 200 mg of EPP-AF<sup>®</sup> or placebo twice daily for six weeks. The primary outcome was the change in treadmill exercise duration (in seconds). Secondary outcomes included total exercise time, functional capacity (measured in metabolic equivalents of task [METs]), high-sensitivity C-reactive protein (hs-CRP) levels, the Seattle Angina Questionnaire (SAQ), and the Canadian Cardiovascular Society (CCS) angina classification. Statistical analysis was performed on an intention-to-treat basis. <b>Results</b>: A total of 59 patients were randomized, with a median follow-up of 6.5 weeks. There was no significant difference in the primary endpoint between groups: the median change in treadmill test time was 39 s in the EPP-AF<sup>®</sup> group versus 30 s in the placebo group (<i>p</i> = 0.83). No improvements were observed in METs, hs-CRP levels, SAQ scores, or CCS class in the EPP-AF<sup>®</sup> group. No major adverse cardiovascular events occurred during the study. <b>Conclusions:</b> EPP-AF<sup>®</sup> did not improve functional capacity, inflammatory markers, or angina symptoms in patients with stable CHD compared to placebo.https://www.mdpi.com/1424-8247/18/6/827propolisgreen propolisanti-inflammatorychronic coronary diseasecoronary heart diseaseangina pectoris
spellingShingle Clara Salles Figueiredo
Luiz Carlos Santana Passos
Caio Rebouças Fonseca Cafezeiro
Rodrigo Morel Vieira de Melo
Tainá Teixeira Viana
Eduardo Jorge Gomes de Oliveira
Andresa Aparecida Berretta
Marcelo Augusto Duarte Silveira
Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
Pharmaceuticals
propolis
green propolis
anti-inflammatory
chronic coronary disease
coronary heart disease
angina pectoris
title Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
title_full Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
title_fullStr Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
title_full_unstemmed Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
title_short Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?—A Pilot Randomized Trial
title_sort does green brazilian propolis extract improve functional capacity in symptomatic chronic coronary disease a pilot randomized trial
topic propolis
green propolis
anti-inflammatory
chronic coronary disease
coronary heart disease
angina pectoris
url https://www.mdpi.com/1424-8247/18/6/827
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