Monday, March 8, 2010

Is resveratrol the new aspirin for heart attacks?

The newswires are abuzz this month about a recent report suggesting that resveratrol, the polyphenol molecule from red wine, helps restore blood flow and limit muscle damage after heart attack. The typical headline reads something like “Red wine component pill successful during heart attacks” or something similar, with the clear implication that some sort of clinical trial has been done. In fact, it was a study in mice, and while the results were impressive it is only one small step toward the giant leap of clinical practice. What happens in mice doesn’t always happen in humans, so we are no where near the point where your cardiologist is going to give you a resveratrol pill when you show up in the E.R. with chest pain.


Nevertheless, the results are encouraging. What happens in a heart attack is that the plaques that build up in the coronary arteries that feed the heart muscle cause a clot to form, completely obstructing the vessel and depriving the heart of oxygen. It’s similar to what happens to the brain in a stroke. This oxygen starvation is called “ischemia” and when the clot is dissolved and blood flow re-established, it is called “reperfusion.” Paradoxically, this rush of blood flow releases toxins that have built up in the cells, resulting in what is called “ischemia-reperfusion injury.” Transplant surgeons deal with a related issue. The ability of resveratrol to counteract the detrimental effects of ischemia-reperfusion has been well documented in numerous studies, and the recent one in mice confirms those findings. But a mouse heart is tiny, and the question of whether the same effect applies in the large muscle mass of the human heart remains speculative.

A likely scenario is that one of the synthetic derivatives of resveratrol, many of which are much more potent, will emerge as a viable therapy for heart attack and stroke. But clinical studies on resveratrol are few in number, as I have pointed out here recently.

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