Aged Garlic Extract Study (AGE)

Aged Garlic Extract (Kyolic) Study at Lund University, Sweden

The primary intention of the study is to examine the effect of aged garlic extract (AGE) on the absolute change in coronary artery calcium (CAC). The second intention is to examine the effect of AGE on inflammatory biomarkers and microcirculation. It is a double blind placebo controlled study. The participants will ingest AGE during a period of one year. The CAC will be controlled by computer tomography (CT) scan; the inflammatory biomarkers through blood sample test and the microcirculation through laser speckel imagining and laser doppler before and after the one year period of AGE ingestion.

Study Overview

• Status: Completed
• Conditions: Coronary Artery Disease; Biomarkers; Microcirculation
• Intervention / Treatment: Dietary supplement: Placebo; Dietary supplement: Aged Garlic Extract

Detailed Description

Objectives:

Effect on coronary artery atherosclerosis / the progression of atherosclerosis Effect on inflammatory and oxidation biomarkers Cholesterol lowering effect Effect on microcirculation

Type of study:

Randomized double blind controlled trial

Number of patients: 80 patients

Duration of the study:

The patients will be studied for one year after they have entered the study. The total time of the study duration from the including date of the first patient to the analysis of the last patient entering the study estimated to be 2-3 years. An inclusion rate off 1 to 2 patients per week.

Treatment:

Dose: Treated with a placebo capsule or a capsule containing a total of AGE 2400 mg daily for 1 year (2 Kyolic capsule (600 mg) twice daily).

Methods:

Placebo-controlled double blind randomized trial to determine whether AGE can influence the rate of atherosclerosis plaque burden measured by coronary artery calcium, improve vascular function and microcirculation and favorably change biomarkers of oxidative stress.

Randomization:

The participants are assigned to AGE or placebo in a double-blinded manner, using numbered containers assigned to a computer-generated randomization chart by a nurse coordinator.

• Study Type: Interventional
• Enrollment (Anticipated): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Sweden
  • Lund, Sweden, 22241
    • Skane University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 38 years to 73 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• CAC score >10
• Framingham risk score (10 % or above)
• Subjects are required to be on stable concomitant medications for at least 12 weeks prior to randomization
• Subjects with diabetic must have HbA1C < 8.0, and stable HbA1C level variation range within 0.5% for three months.

Exclusion Criteria:

• Hypersensitivity to AGE therapy,
• Unstable medical, psychiatric, or substance abuse disorder that may interfere with continuation in the study,
• Weight ≥325 pounds,
• Bleeding disorder,
• History of myocardial infarction,
• Stroke
• Life-threatening arrhythmia within prior 6 months,
• Resting hypotension (systolic < 90 mmHg) or hypertension (resting blood pressure >170/110)
• Heart failure NYHA class III or IV,
• History of malignancy within the last 5 years (other than skin cancer) or evidence of active cancer which would require concomitant cancer chemotherapy
• Serum creatinine >1.4 mg/dl
• Triglycerides > 400 at baseline visit
• Diabetic subjects with HbA1C > 8 %,
• Drug or alcohol abuse
• Conditions interfering with accurate assessment of coronary calcification (metal clips, bypass patients, intracoronary stents) and drug absorption (partial ileal bypass or malabsorption syndrome).
• Current use of anticoagulants (except for antiplatelet agents)
• Chronic renal failure
• Liver failure
• Hematological or biochemical values at baseline visit outside the reference ranges considered as clinically significant.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Other
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Aged Garlic Extract; The participants will ingest 600 mg of Aged Garlic Extract in two capsules two times a day i.e. 1200 mg/day during a period of one year.	Dietary supplement: Aged Garlic Extract; Other Names: Kyolic
Placebo Comparator: Placebo; The participants will ingest 600 mg of placebo in two capsules two times a day i.e. 1200 mg/day during a period of one year.	Dietary supplement: Placebo

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in coronary artery calcium (CAC) score	CAC is to be defined as a plaque of at least three contiguous pixels (area 1.02 mm 2) with a density of > 130 Hounsfield units. The lesion score are to be calculated by multiplying the lesion area by a density factor derived from the maximal Hounsfield unit within this area, as described by Agatston S, Janowitz WR, Hildner FJ et al. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 1990; 15: 827-832. CAC score is measured at baseline and after one year follow-up and the difference is calculated.	One year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The changes in inflammatory biomarkers.	Changes in C-reactive protein (CRP mg/L)	One Year
The changes in Interleukin-6 (IL-6)	Changes in IL-6 (ng/L)	One Year
The changes in inflammatory biomarkers.	Changes in Homocystein (µmol/L)	One Year
The changes in the microcirculation measured by Laser Doppler velocimetry	Laser Doppler Flowmetry (LDF) is a non-invasive method to estimate the blood perfusion in the microcirculation. The advantage of the technique is that LDF provide a continuous or near continuous record of the microvascular blood flow. No current laser Doppler instrument can present absolute perfusion values (e.g. ml/min/100 gram tissue). Measurements are expressed as perfusion units (PU) which are arbitrary. The changes in PU will be measured.	One Year
Changes in Low Density Lipoprotein	Changes of Low Density Lipoprotein (LDL) mmol/L	One Year
Changes in Triglycerides	Changes of Triglycerides mmol/L.	One Year
Changes in Cholesterol	Changes of cholesterol mmol/L.	One Year
Changes in High Density Lipoprotein	Changes of High Density Lipoprotein(HDL) mmol/L,	One Year
Changes in lipid profile	Apolipoprotein B (mmol/L)/Apolipoprotein A1 (mmol/L)	One Year
Changes in blood sugar	Changes in fastening blood glucose measured as mmol/L	One Year
Changes in Blood pressure	Changes of blood pressure Systolic and Diastolic presented as mmHg.	One Year
Changes in BMI	Changes in BMI measured as weight (kg) and height (m) and will be combined to report BMI in kg/m^2	One Year

Collaborators and Investigators

• Sponsor: Lund University Hospital
• Investigators: Principal Investigator: Sandra Lindstedt, MD, PhD, Skane University Hospital

Publications and helpful links

General Publications

• Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R. Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol. 1990 Mar 15;15(4):827-32. doi: 10.1016/0735-1097(90)90282-t.
• Lindstedt S, Malmsjo M, Hansson J, Hlebowicz J, Ingemansson R. Microvascular blood flow changes in the small intestinal wall during conventional negative pressure wound therapy and negative pressure wound therapy using a protective disc over the intestines in laparostomy. Ann Surg. 2012 Jan;255(1):171-5. doi: 10.1097/SLA.0b013e31823c9ffa.
• Lindstedt S, Malmsjo M, Hlebowicz J, Ingemansson R. Comparative study of the microvascular blood flow in the intestinal wall, wound contraction and fluid evacuation during negative pressure wound therapy in laparostomy using the V.A.C. abdominal dressing and the ABThera open abdomen negative pressure therapy system. Int Wound J. 2015 Feb;12(1):83-8. doi: 10.1111/iwj.12056. Epub 2013 Mar 21.
• Lindstedt S, Malmsjo M, Ingemansson R. No hypoperfusion is produced in the epicardium during application of myocardial topical negative pressure in a porcine model. J Cardiothorac Surg. 2007 Dec 6;2:53. doi: 10.1186/1749-8090-2-53.
• Lindstedt S, Malmsjo M, Ingemansson R. Blood flow changes in normal and ischemic myocardium during topically applied negative pressure. Ann Thorac Surg. 2007 Aug;84(2):568-73. doi: 10.1016/j.athoracsur.2007.02.066.
• Budoff MJ, Ahmadi N, Gul KM, Liu ST, Flores FR, Tiano J, Takasu J, Miller E, Tsimikas S. Aged garlic extract supplemented with B vitamins, folic acid and L-arginine retards the progression of subclinical atherosclerosis: a randomized clinical trial. Prev Med. 2009 Aug-Sep;49(2-3):101-7. doi: 10.1016/j.ypmed.2009.06.018. Epub 2009 Jun 30.
• Wlosinska M, Nilsson AC, Hlebowicz J, Fakhro M, Malmsjo M, Lindstedt S. Aged Garlic Extract Reduces IL-6: A Double-Blind Placebo-Controlled Trial in Females with a Low Risk of Cardiovascular Disease. Evid Based Complement Alternat Med. 2021 Mar 31;2021:6636875. doi: 10.1155/2021/6636875. eCollection 2021.
• Wlosinska M, Nilsson AC, Hlebowicz J, Hauggaard A, Kjellin M, Fakhro M, Lindstedt S. The effect of aged garlic extract on the atherosclerotic process - a randomized double-blind placebo-controlled trial. BMC Complement Med Ther. 2020 Apr 29;20(1):132. doi: 10.1186/s12906-020-02932-5.

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2016
• Primary Completion (Actual): June 1, 2019
• Study Completion (Actual): June 1, 2019

Study Registration Dates

• First Submitted: February 26, 2019
• First Submitted That Met QC Criteria: February 28, 2019
• First Posted (Actual): March 1, 2019

Study Record Updates

• Last Update Posted (Actual): June 11, 2019
• Last Update Submitted That Met QC Criteria: June 8, 2019
• Last Verified: June 1, 2019

More Information

Terms related to this study

• Keywords: garlic
• Additional Relevant MeSH Terms: Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Coronary Disease; Coronary Artery Disease
• Other Study ID Numbers: DNR2016/745

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: Undecided

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: Yes