The incidence and prevalence of cardiovascular diseases are still rising. The principal mechanism that drives them is atherosclerosis, an affection given by dyslipidemia and a pro-inflammatory state. Paraoxonase enzymes have a protective role due to their ability to contribute to antioxidant and anti-inflammatory pathways, especially paraoxonase 1 (PON1). PON1 binds with HDL (high-density lipoprotein), and high serum levels lead to a protective state against dyslipidemia, cardiovascular diseases, diabetes, stroke, nonalcoholic fatty liver disease, and many others. Modulating PON1 expression might be a treatment objective with significant results in limiting the prevalence of atherosclerosis. Lifestyle including diet and exercise can raise its levels, and some beneficial plants have been found to influence PON1 levels; therefore, more studies on herbal components are needed. Our purpose is to highlight the principal roles of Praoxonase 1, its implications in dyslipidemia, cardiovascular diseases, stroke, and other diseases, and to emphasize plants that can modulate PON1 expression, targeting the potential of some flavonoids that could be introduced as supplements in our diet and to validate the hypothesis that flavonoids have any effects regarding PON1 function.

Background/Objectives: Heart failure (HF) with reduced ejection fraction (EF) has, in more than 50% of cases, an ischemic etiology and continues to be associated with increased mortality and morbidity despite all the progress registered in the field of medical therapy and interventional revascularization. Myocardial revascularization is extensively used in clinical practice based on the traditional concept that it can improve myocardial function and outcome in ischemic HF. This review is aimed at presenting current knowledge regarding revascularization in patients with chronic ischemic HF and reduced EF. Methods: The impact of revascularization on symptomatology, left ventricle reverse remodeling, major adverse cardiac events (MACEs), and the role of complete revascularization and of percutaneous interventional revascularization in chronic total occlusion (PCI-CTO) were analyzed. The best therapeutic strategies, revascularization and/or optimal medical therapy (OMT), are debated in different categories of patients, in order to identify who will benefit more from revascularization strategies. Results: Based on the long-term results of the STICH trial incorporated in the guidelines with a class I-b recommendation, coronary artery bypass graft (CABG) remains the main modality of revascularization for prognostic improvement in ischemic HF with multivessel disease. But real-life patients are usually old with multiple comorbidities and high surgical risk. In this category, the Heart Team opinion is required to evaluate the probability of complete revascularization and to choose between percutaneous coronary intervention (PCI) and CABG according to clinical status and coronary anatomy. Conclusions: However, until further studies are available, the results of the REVIVED-BCIS2 trial encourage OMT over PCI in patients with ischemic cardiomyopathy. The available randomized controlled trials (RCTs) showed improved angina and quality of life in PCI-CTO versus OMT, but the effect on MACEs was not demonstrated.

Vascular calcification and atherosclerotic arterial disease are complex processes involving multiple inhibitory and pro-calcific mechanisms. Matrix Gla protein (MGP) is an important inhibitor of vascular calcification, and its inactive dephosphorylated–uncarboxylated form (dp-ucMGP) has been proposed as a biomarker of cardiovascular risk. The present study aimed to evaluate the association of circulating dp-ucMGP, total MGP (tMGP), and Fetuin-A concentrations as markers for calcification associated with the presence of fibrocalcific plaques and/or arterial stenosis. A total of 160 patients were included in this observational study. Patients were classified according to the presence of fibrocalcific plaques and/or arterial stenosis. The study group included 136 patients, whereas 24 patients without fibrocalcific plaques or stenosis served as the control group. dp-ucMGP concentrations were significantly higher in the study group [1.29 vs. 1.07, p = 0.047]. In contrast, no significant differences were observed for tMGP [15.79 vs. 12.67, p = 0.532] or Fetuin-A [388.50 vs. 403.05, p = 0.894]. Glucose concentrations were significantly higher in the study group (p < 0.001), together with significant differences in fibrinogen, urea, creatinine, LDL cholesterol, and uric acid. Spearman correlation analysis showed weak positive correlations between dp-ucMGP and urea (ρ = 0.175, p = 0.034), creatinine (ρ = 0.183, p = 0.026), and triglycerides (ρ = 0.197, p = 0.017). Higher circulating dp-ucMGP concentrations were associated with the presence of fibrocalcific plaques and/or arterial stenosis, whereas tMGP and Fetuin-A did not differ significantly between groups. These findings support the potential relevance of dp-ucMGP as a biomarker associated with fibrocalcific and stenotic arterial disease. Further studies are required to determine its independent predictive value and clinical utility.

Background: Physical activity is a key modifiable determinant of cardiovascular risk, yet whether its protective association with coronary artery disease (CAD) severity in patients with myocardial infarction (MI) is mediated by body mass index (BMI) remains uncertain. Methods: This cross-sectional study included 294 adults admitted with MI and angiographically confirmed MI. Daily preadmission physical activity, as a score, BMI, cardiovascular risk factors and angiographic CAD extent (single-, double-, or triple-vessel disease) were analyzed. Multivariable ordinal logistic regression assessed independent associations of preadmission physical activity with CAD severity. Mediation analysis evaluated BMI as an intermediary using non-parametric bootstrap resampling with 2000 iterations and 95% confidence intervals (CIs). Results: Higher preadmission physical activity was independently associated with lower CAD severity after adjustment for age, sex, smoking, hypertension, diabetes, hyperlipidemia and BMI (β = −0.54, p < 0.001). BMI showed no independent association with CAD severity (β = 0.009, p = 0.76). Bootstrapped mediation analysis demonstrated no significant indirect effect through BMI (mean indirect effect 0.00044; 95% CI −0.00184 to 0.00360). Conclusions: In patients with MI, the inverse relationship between physical activity and CAD severity appears independent of BMI, suggesting weight-independent cardioprotective mechanisms. Promotion of habitual physical activity should remain a central component of secondary cardiovascular prevention regardless of body weight.

Background: Intense physical activity is known to generate high levels of oxidative stress, and supplementation with bioactive products with powerful antioxidant effects is often recommended. In this context, the present study aims to evaluate the potential benefits of supplementing the diet of professional combat fighters with a new bioactive formulation based on Aronia melanocarpa (black chokeberry) and bee pollen, a natural combination with a balanced ratio of macro- and micronutrients, rich in proteins and polyphenols. Methods: A total of 31 professional combat fighters were selected to participate in this study. Due to allergic medical history, two were excluded, and the remaining 29 were divided into two groups: 14 in the control and 15 in the supplementation group. The supplemented group consumed daily 40 g of novel supplement based on a combination of dried black chokeberry and bee pollen (1:2 ratio) for 4 weeks. Results: A statistically significant increase in plasma antioxidant capacity was observed in the supplemented group compared to control related to the time and group factors at the end of this study. During this study, a significant increase in neutrophils was recorded in both groups. Supplementation with black chokeberry and bee pollen generated no significant modifications in inflammatory markers, body composition, glycemia, maximum aerobic capacity, blood glycemia, hemoglobin or red cell line. Conclusion: This clinical study pointed out a positive result in terms of plasma antioxidant capacity upon administration of the novel nutraceutical formulation.