Background:

2

Resveratrol is a non-flavonoid polyphenol that shows promise in reducing pro-inflammatory factors and maintaining endothelial function

which hints at its potential role in slowing atherosclerosis and preventing acute coronary events.

Objective:

2

To study the cardioprotective effects of resveratrol on inflammatory mediators and endothelial function in patients with coronary artery disease (CAD).

Methods:

2

A thorough search was conducted in databases (Cochrane Library

ProQuest

PubMed

LILACS

ScienceDirect

Springer

Taylor&Francis

CNKI

Wanfang

and Weipu) until September 24

2023. The vasopro-inflammatory mediators

endothelial function and outcomes related to cardiovascular events were observed. Titles and abstracts were assessed

and bias was evaluated with Cochrane RoB 2.0. Heterogeneity of results was explored by meta-regression

certainty of evidence was assessed by the GRADE system

and conclusive evidence was enhanced by trial sequence analysis.

Results:

2

Ten randomized controlled

trials

and 3

animal studies

investigated resveratrol's impact on inflammatory mediators and endothelial function. In primary prevention studies

meta-analysis showed a significant reduction (95% CI: –0.73 to –0.20;

P

=0.0005) in tumor necrosis factor-α (TNF-α) expression with resveratrol

demonstrating a dose-dependent relationship. No significant difference was observed in interleukin-6 (IL-6) expression with

P

=0.58 for primary prevention and

P

=0.57 for secondary prevention. Vascular endothelial nitric oxide synthase (eNOS) expression was significantly increased after resveratrol pre-treatment following CAD events. Secondary prevention studies yielded no significant results; however

meta-regression identified associations between age

hypertension

and lower doses with the extent of TNF-α alterations. High certainty of evidence supported TNF-α reduction

while evidence for IL-6 reduction and eNOS elevation was deemed low.

Conclusions:

2

Resveratrol reduces TNF-α in individuals at risk for CAD

specifically 15 mg per day. However

its usefulness in patients with confirmed CAD is limited due to factors such as age

high blood pressure

and insufficient dosage. Due to the small sample size

the reduction of IL-6 is inconclusive. Animal studies suggest that resveratrol enhances endothelial function by increasing eNOS. (PROSPERO registration No. CRD42023465234)