Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Center of Excellence for Redox Balance Research in Cardiovascular and Metabolic Disorders, 34000 Kragujevac, Serbia.
Biomolecules. 2024 Aug 7;14(8):956. doi: 10.3390/biom14080956.
The use of non-vitamin K antagonist oral anticoagulants (NOACs) has brought a significant progress in the management of cardiovascular diseases, considered clinically superior to vitamin K antagonists (VKAs) particularly in the prevention and treatment of thromboembolic events. In addition, numerous advantages such as fixed dosing, lack of laboratory monitoring, and fewer food and drug-to-drug interactions make the use of NOACs superior to VKAs. While NOACs are synthetic drugs prescribed for specific conditions, nattokinase (NK) is a natural enzyme derived from food that has potential health benefits. Various experimental and clinical studies reported the positive effects of NK on the circulatory system, including the thinning of blood and the dissolution of blood clots. This enzyme showed not only fibrinolytic activity due to its ability to degrade fibrin, but also an affinity as a substrate for plasmin. Recent studies have shown that NK has additional cardioprotective effects, such as antihypertensive and anti-atherosclerotic effects. In this narrative review, we presented the cardioprotective properties of two different approaches that go beyond anticoagulation: NOACs and NK. By combining evidence from basic research with clinical findings, we aim to elucidate the comparative cardioprotective efficacy of these interventions and highlight their respective roles in modern cardiovascular care.
非维生素 K 拮抗剂口服抗凝剂 (NOACs) 的应用在心血管疾病的治疗中带来了重大进展，被认为在预防和治疗血栓栓塞事件方面优于维生素 K 拮抗剂 (VKAs)，尤其具有临床优势。此外，NOACs 还具有固定剂量、无需实验室监测以及较少的药物相互作用等诸多优点，优于 VKAs。虽然 NOACs 是为特定疾病开具的合成药物，但纳豆激酶 (NK) 是一种源自食物的天然酶，具有潜在的健康益处。多项实验和临床研究报告了 NK 对循环系统的积极影响，包括血液稀释和血栓溶解。这种酶不仅由于其降解纤维蛋白的能力具有纤维蛋白溶解活性，而且还作为纤溶酶的底物具有亲和力。最近的研究表明，NK 还具有额外的心脏保护作用，如降压和抗动脉粥样硬化作用。在本叙述性综述中，我们提出了两种超越抗凝作用的不同方法的心脏保护特性：NOACs 和 NK。通过将基础研究证据与临床发现相结合，我们旨在阐明这些干预措施的相对心脏保护效果，并强调它们在现代心血管治疗中的各自作用。
