Impact of astaxanthin on oxidative markers, uric acid, and clinical symptoms in heart failure: a randomized clinical trial

BACKGROUND AND AIMS: Chronic heart failure (HF) is often linked to increased oxidative stress and metabolic issues like high uric acid, which can worsen outcomes. Astaxanthin (ASX), a strong antioxidant, may help reduce these harmful effects. This study aimed to investigate the effects of ASX supplementation on oxidative stress markers as the primary outcome and clinical symptoms in patients with HF. METHODS: In this randomized, double-blind, placebo-controlled clinical trial, 80 patients with HF were enrolled and randomly assigned to receive either ASX (20 mg/day) or a placebo (20 mg/day of maltodextrin) for 8 weeks. Biomarkers including total antioxidant capacity (TAC), malondialdehyde (MDA), superoxide dismutase (SOD), serum UA, and clinical symptoms (dyspnea, fatigue, appetite) were assessed pre-and post-intervention. RESULTS: After eight weeks, compared to the placebo group, participants receiving ASX supplementation showed a significant increase in TAC (0.12 vs. -0.04 mmol/L, P = 0.002) and SOD levels (156.92 vs. 36.14 U/mL, P < 0.001). In contrast, the ASX group demonstrated significantly greater reductions in MDA (-2.19 vs. -0.68 nmol/L, P < 0.001) and serum UA levels (-1.82 vs. -0.63 mg/dl, P = 0.003) compared to placebo. Furthermore, among ASX treated patients, improvements in dyspnea and fatigue were statistically significant (P < 0.001), while the increase in appetite was only marginally significant (P = 0.071). CONCLUSION: These findings suggest that ASX supplementation may be effective in improving oxidative stress biomarkers and clinical status in patients with HF. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20200429047235N3. Registered on 26 March 2024, prior to the enrollment of the first participant. http://irct.behdasht.gov.ir/trial/75913 .