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Marine-derived polysaccharides (MDPs)\u2014including fucoidan, alginate, laminarin, carrageenan, and chitosan\u2014exhibit a spectrum of bioactivities relevant to ASCVD pathogenesis, such as anti-inflammatory, antioxidant, lipid-modulatory, antithrombotic, and endothelial-protective effects. In this critical review, we synthesize preclinical and emerging clinical evidence on the pharmacokinetics, mechanisms of action, and therapeutic potential of these compounds. We highlight translational challenges, including structural variability, poor oral bioavailability, and limited human data, and propose strategies to overcome these barriers, such as molecular standardization, novel delivery systems, and well-designed clinical trials. MDPs represent promising natural therapeutics for ASCVD prevention and treatment, warranting further investigation in rigorous human studies.<\/jats:p>","DOI":"10.3390\/md23080325","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T16:30:36Z","timestamp":1755016236000},"page":"325","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Marine-Derived Polymers\u2013Polysaccharides as Promising Natural Therapeutics for Atherosclerotic Cardiovascular Disease"],"prefix":"10.3390","volume":"23","author":[{"given":"Edmond Leonard","family":"Jim","sequence":"first","affiliation":[{"name":"Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sam Ratulangi University, Manado 95115, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin Leopold","family":"Jim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Royal Taruma Hospital, Jakarta 11470, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8165-2072","authenticated-orcid":false,"given":"Reggie","family":"Surya","sequence":"additional","affiliation":[{"name":"Department of Food Technology, Faculty of Engineering, Bina Nusantara University, Jakarta 11480, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4777-624X","authenticated-orcid":false,"given":"Happy Kurnia","family":"Permatasari","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Biomolecular, Faculty of Medicine, Universitas Brawijaya, Malang 65145, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2151-0854","authenticated-orcid":false,"given":"Fahrul","family":"Nurkolis","sequence":"additional","affiliation":[{"name":"Master of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya 60131, Indonesia"},{"name":"Institute for Research and Community Service, State Islamic University of Sunan Kalijaga (UIN Sunan Kalijaga), Yogyakarta 55281, Indonesia"},{"name":"Medical Research Center of Indonesia, Surabaya 60286, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.clinthera.2023.09.020","article-title":"Global Trends in Atherosclerotic Cardiovascular Disease","volume":"45","author":"Nedkoff","year":"2023","journal-title":"Clin. 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