From the Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy (F.V., D.P., P.P.).
Mediterranea Cardiocentro, Napoli, Italy (F.V., P.P., R.C.).
Circ Res. 2020 May 8;126(10):1415-1442. doi: 10.1161/CIRCRESAHA.120.315892. Epub 2020 May 7.
Previous studies reported an inverse association between healthy dietary patterns (such as Mediterranean diet) and the incidence of cardiovascular events. As the mechanism accounting for cardiovascular disease is prevalently due to the atherothrombosis, where a pivotal role is played by platelet activation, it would be arguable that diets with protective effects against cardiovascular disease exert an anti-atherothrombotic effect via inhibition of platelet activation. There are several and sparse typologies of studies, which investigated if single nutrients by diets recognized as having cardiovascular protection may exert an antithrombotic effect. The most investigated nutrients are key components of the Mediterranean diets such as fruits and vegetables, fish, olive oil, and wine; other diets with protective effects include nuts and cocoa. Here we summarize experimental and human interventional studies which investigated the antithrombotic effects of such nutrients in experimental models of thrombosis or analyzed biomarkers of clotting, platelet, and fibrinolysis activation in human; furthermore in vitro studies explored the underlying mechanism at level of several cell lines such as platelets or endothelial cells. In this context, we analyzed if nutrients affect simultaneously or separately clotting, platelet, and fibrinolysis pathways giving special attention to the relationship between oxidative stress and thrombosis as most nutrients are believed to possess antioxidant properties.
先前的研究报告称，健康的饮食模式（如地中海饮食）与心血管事件的发生呈负相关。由于导致心血管疾病的机制主要是动脉粥样硬化血栓形成，血小板的激活起着关键作用，因此可以说，具有预防心血管疾病作用的饮食通过抑制血小板的激活发挥抗动脉粥样硬化血栓形成的作用。有一些为数不多的研究类型，研究了饮食中被认为具有心血管保护作用的单一营养素是否可能产生抗血栓作用。研究最多的营养素是被认为具有保护作用的地中海饮食的关键成分，如水果和蔬菜、鱼、橄榄油和葡萄酒；其他具有保护作用的饮食包括坚果和可可。在这里，我们总结了在血栓形成的实验模型中或在人类凝血、血小板和纤维蛋白溶解激活的生物标志物中分析这些营养素的抗血栓作用的实验和人体干预研究；此外，体外研究在血小板或内皮细胞等几种细胞系水平上探讨了潜在的机制。在这种情况下，我们分析了营养素是否同时或分别影响凝血、血小板和纤维蛋白溶解途径，并特别关注氧化应激与血栓形成之间的关系，因为大多数营养素都被认为具有抗氧化特性。
