Complementary Alternative Cardiovascular Medicine

114 Alternative Cardiovascular Medicine
S-nitrosoglutathione is an NO donor with preferential action on platelets.
Langford et al. (58) demonstrated a significant inhibition in the
coronary angioplasty-induced increase in platelet surface expression of
P-selectin and glycoprotein IIb/IIIa with glutathione administration
resulting in platelet inhibition in seven patients undergoing
angioplasty. In a subsequent report, the same authors (59) verified these
results in 40 patients presenting with AMI (n = 20) and unstable angina
(n = 20).
Platelet inhibition and improved endothelial-mediated vasomotion of
atherosclerotic vessels by glutathione suggest a role in acute coronary
syndromes or PCI. However, there have, been no appropriate studies in
that regard.
Adverse reactions: None reported
Contraindications: Hypersensitivity
Usual dosage: 50–60 mg/d
SELENIUM
Selenium is an essential trace element. It enters the food chain through
incorporation into plant protein via the soil. It has structural and enzymic
roles, and it is a powerful antioxidant, regulating the activity of the
glutathione peroxidase enzymes, which catalyze the detoxification of
peroxide and organic hydroperoxides. It has been mostly used to reduce
cancer-related mortality.
Role in CVD
Selenium deficiency is a rare cause of dilated, congestive cardiomyopathy.
In Asia and Africa, cardiomyopathy resulting from dietary selenium
deficiency is known as Keshan disease (60). It is usually seen in
patients with malabsorption or long-term selenium-deficient parenteral
alimentation. Selenium deficiency leads to depletion of the enzymes that
protect cell membranes from free radicals. Once fully developed, cardiomyopathy
is irreversible. Prophylactic administration of sodium selenite
tablets prevents new cases of cardiomyopathy in selenium-deficient
geographic areas.
Selenium deficiency has also been reported to promote platelet aggregation
(61). This deficiency inhibits prostacyclin synthetase, causing
reduced prostacyclin and increased thromboxane activity, which is a
vasoconstrictor and platelet aggregator. Correlation between low selenium
levels and increased MI has been reported (62), and some reports
have suggested the protective role of high serum selenium levels. How-