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

2025-10-29
BMC cardiovascular disorders 25(1)
- Shirin Ghotboddin Mohammadi
- Davood Shafie
- Awat Feizi
- Mohammad Bagherniya
- Ali-Reza Ahmadi
- Marzieh Kafeshani

PubMed: 41162864
DOI: 10.1186/s12872-025-05260-z

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 80
Population: 80 patients with HF
Methods: randomized, double-blind, placebo-controlled clinical trial, 20 mg/day ASX or placebo for 8 weeks
Blinding: Double-blind
Duration: 8 weeks

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 .

Research Insights

Astaxanthin→Improved Appetite
the increase in appetite was only marginally significant (P = 0.071)
Effect
Neutral
Effect size
Small
Dose
20 mg/day
Astaxanthin→Improved Dyspnea
among ASX treated patients, improvements in dyspnea ... were statistically significant (P < 0.001)
Effect
Beneficial
Effect size
Small
Dose
20 mg/day
Astaxanthin→Increased Antioxidant Enzyme Levels
participants receiving ASX supplementation showed a significant increase in ... SOD levels (156.92 vs. 36.14 U/mL, P < 0.001)
Effect
Beneficial
Effect size
Moderate
Dose
20 mg/day
Astaxanthin→Increased Total Serum Antioxidant Capacity
participants receiving ASX supplementation showed a significant increase in TAC (0.12 vs. -0.04 mmol/L, P = 0.002)
Effect
Beneficial
Effect size
Small
Dose
20 mg/day
Astaxanthin→Reduced Fatigue
among ASX treated patients, improvements in ... fatigue were statistically significant (P < 0.001)
Effect
Beneficial
Effect size
Small
Dose
20 mg/day
Astaxanthin→Reduced Malondialdehyde
the ASX group demonstrated significantly greater reductions in MDA (-2.19 vs. -0.68 nmol/L, P < 0.001)
Effect
Beneficial
Effect size
Moderate
Dose
20 mg/day
Astaxanthin→Reduced Uric Acid Levels
the ASX group demonstrated significantly greater reductions in ... serum UA levels (-1.82 vs. -0.63 mg/dl, P = 0.003)
Effect
Beneficial
Effect size
Moderate
Dose
20 mg/day

Adverse Events Reported

Astaxanthin→Overall tolerability
The abstract does not mention any adverse events or side effects related to astaxanthin supplementation.
Finding
Reported