{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:21:25Z","timestamp":1760059285710,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T00:00:00Z","timestamp":1748649600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Inflammation plays a critical role in the progression of coronary heart disease (CHD). Low-dose colchicine has shown promise in reducing cardiovascular events, and green Brazilian propolis extract (EPP-AF\u00ae (standardized Brazilian green propolis extract) was provided by Apis Flora Indl. Coml. Ltda, Ribeir\u00e3o Preto, SP, Brazil), known for its anti-inflammatory properties, may offer additional therapeutic benefits. This pilot study aimed to evaluate whether six weeks of EPP-AF\u00ae supplementation improves functional capacity assessed by treadmill exercise testing. Methods: This was a randomized, double-blind, placebo-controlled pilot study conducted at a coronary disease clinic in Brazil. Patients aged \u2265 18 years with stable CHD receiving optimized medical therapy were randomized in a 2:1 ratio to receive either 200 mg of EPP-AF\u00ae or placebo twice daily for six weeks. The primary outcome was the change in treadmill exercise duration (in seconds). Secondary outcomes included total exercise time, functional capacity (measured in metabolic equivalents of task [METs]), high-sensitivity C-reactive protein (hs-CRP) levels, the Seattle Angina Questionnaire (SAQ), and the Canadian Cardiovascular Society (CCS) angina classification. Statistical analysis was performed on an intention-to-treat basis. Results: A total of 59 patients were randomized, with a median follow-up of 6.5 weeks. There was no significant difference in the primary endpoint between groups: the median change in treadmill test time was 39 s in the EPP-AF\u00ae group versus 30 s in the placebo group (p = 0.83). No improvements were observed in METs, hs-CRP levels, SAQ scores, or CCS class in the EPP-AF\u00ae group. No major adverse cardiovascular events occurred during the study. Conclusions: EPP-AF\u00ae did not improve functional capacity, inflammatory markers, or angina symptoms in patients with stable CHD compared to placebo.<\/jats:p>","DOI":"10.3390\/ph18060827","type":"journal-article","created":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T12:27:09Z","timestamp":1748867229000},"page":"827","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Green Brazilian Propolis Extract Improve Functional Capacity in Symptomatic Chronic Coronary Disease?\u2014A Pilot Randomized Trial"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7722-9087","authenticated-orcid":false,"given":"Clara Salles","family":"Figueiredo","sequence":"first","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina e Sa\u00fade (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil"},{"name":"Hospital Ana Nery, Salvador 40301-155, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz Carlos Santana","family":"Passos","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina e Sa\u00fade (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil"},{"name":"Hospital Ana Nery, Salvador 40301-155, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5960-2952","authenticated-orcid":false,"given":"Caio Rebou\u00e7as Fonseca","family":"Cafezeiro","sequence":"additional","affiliation":[{"name":"Hospital Ana Nery, Salvador 40301-155, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3927-778X","authenticated-orcid":false,"given":"Rodrigo Morel Vieira","family":"de Melo","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina e Sa\u00fade (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil"},{"name":"D\u2019Or Institute for Research and Education (IDOR), Hospital S\u00e3o Rafael, Avenida S\u00e3o Rafael 2152, S\u00e3o Marcos, Salvador 41253-190, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-8246","authenticated-orcid":false,"given":"Tain\u00e1 Teixeira","family":"Viana","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Medicina e Sa\u00fade (Graduate Program in Medicine and Health), Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador 40110-060, BA, Brazil"},{"name":"D\u2019Or Institute for Research and Education (IDOR), Hospital S\u00e3o Rafael, Avenida S\u00e3o Rafael 2152, S\u00e3o Marcos, Salvador 41253-190, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo Jorge Gomes","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Hospital Ana Nery, Salvador 40301-155, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andresa Aparecida","family":"Berretta","sequence":"additional","affiliation":[{"name":"Development and Innovation Department, Apis Flora Indl. Coml. Ltd., Rua Triunfo 945, Subsetor Sul 3, Ribeir\u00e3o Preto 14020-670, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6808-0540","authenticated-orcid":false,"given":"Marcelo Augusto Duarte","family":"Silveira","sequence":"additional","affiliation":[{"name":"D\u2019Or Institute for Research and Education (IDOR), Hospital S\u00e3o Rafael, Avenida S\u00e3o Rafael 2152, S\u00e3o Marcos, Salvador 41253-190, BA, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E9","DOI":"10.1161\/CIR.0000000000001168","article-title":"2023 AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA Guideline for the Management of Patients with Chronic Coronary Disease: A Report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"148","author":"Virani","year":"2023","journal-title":"Circulation"},{"key":"ref_2","first-page":"e210012","article-title":"Prevalence of Angina Pectoris and Associated Factors in the Adult Population of Brazil: National Survey of Health, 2019","volume":"24","author":"Malta","year":"2021","journal-title":"Rev. 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