Iranian Heart Journal

Iranian Heart Journal

Efficacy and Safety of Lasunairandadi Kashayam, an Ayurvedic Formulation, as Adjunctive Therapy in Patients with Coronary Artery Disease: A Randomized Clinical Trial

Document Type : Original Article

Authors
Kasthuri Nair A 1
Arun Pratap 1
Hareendran Nair J 2
Jishnu R 3
1 Department of Kayachikitsa, Pankajakasthuri Ayurveda Medical College and P.G. Center, Killy, Kattakada, Thiruvananthapuram, Kerala, India.
2 Department of Samhitha, Sanskrit and Siddhaanta, Pankajakasthuri Ayurveda Medical College and P.G. Center, Killy, Kattakada, Thiruvananthapuram, Kerala, India.
3 Department of R&D, Pankajakasthuri Herbal Research Foundation, Thiruvananthapuram, Kerala, India.
Abstract
Background: Coronary Artery Disease (CAD) is the leading global cause of mortality, with its prevalence rising alarmingly in developing countries. While conventional treatments have limitations, traditional medicines like the Ayurvedic formulation Lasunairandadi Kashayam (decoction), historically used for cardiovascular conditions, necessitate rigorous scientific validation to confirm their efficacy and safety. The present study aimed to evaluate the use of that formulation as an adjunct therapy for CAD patients.
 
Methods: This randomized clinical trial involved 53 patients diagnosed with CAD, aged 25 to 60 years. Participants were randomly assigned to an intervention group (Lasunairandadi Kashayam plus the standard CAD treatment, n = 26) or a control group (the standard CAD treatment alone, n = 27). The intervention group received a daily dose of Lasunairandadi Kashayam for 90 days (32 mL thrice a day before meals). Primary endpoints assessed included improvements in treadmill test (TMT) scores, dyspnea on exertion, chest heaviness, chest pain, overall cardiovascular health, and lipid profiles.
 
Results: The intervention group showed statistically significant ameliorations in key CAD parameters compared with the standard therapy group. Notable enhancements were observed in TMT scores (from −7.0 ± 5.5 before treatment to +4.41 ± 5.2 after treatment), dyspnea on exertion, chest heaviness, chest pain, and overall cardiovascular health. Significant reductions were recorded in low-density lipoprotein-cholesterol (from 102.63 ± 29.94 before treatment to 89.50 ± 17.56 after treatment) and triglycerides (from 169.09 ± 63.79 before treatment to 145.59 ± 29.34 after treatment) in the intervention group. The safety profile was favorable, with no serious adverse effects reported.
 
Conclusions: Lasunairandadi Kashayam, as an adjunctive therapy to standard CAD treatment, recorded promising results in improving clinical outcomes for CAD patients. This study contributes valuable evidence toward integrating Ayurvedic interventions into mainstream cardiovascular care. (Iranian Heart Journal 2025; 26(1): 35-53)
Keywords
Ameliorations
Diseased vessels
Lasunairandadi Kashayam
Efficacy
Safety
  1. Liang B, Gu N. Traditional Chinese Medicine for Coronary Artery Disease Treatment: Clinical Evidence From Randomized Controlled Trials. Front Cardiovasc Med. (2021) 8:702110. doi:10.3389/fcvm.2021.70211
  2. Tian PP, Li J, Gao J, Li Y. Efficacy and safety of the Shexiang Baoxin Pill for the treatment of coronary artery disease not amenable to revascularisation: study protocol for a randomized, placebo-controlled, double-blinded trial. BMJ Open. (2018) 8: e018052.
  3. Slovinski AP, Hajjar LA, Ince C. “Microcirculation in cardiovascular diseases,” J Cardiothorac Vasc Anesth. (2019) 33:3458–3468.
  4. Hao DC, Xiao PG. Impact of drug metabolism/pharmacokinetics and their relevance upon traditional medicine-based cardiovascular drug research. Curr Drug Metab. (2019) 20:556-74.
  5. Hao PP, Zhang Y. Clinical trials of integrated Chinese and Western medicine in treating cardiovascular disease: the past and the future. Chin J Cardiol. (2019) 47:697-702.
  6. Doenst T, Thiele H, Haasenritter J, Wahlers T, Massberg S, Haverich A. The Treatment of Coronary Artery Disease: Current Status Six Decades After the First Bypass Operation. Deutsches Ärzteblatt International. (2022) 119:716. https://doi.org/10.3238/arztebl.m2022.0277
  7. Pari L, Amarnath Satheesh M. Antidiabetic effect of Boerhavia diffusa: effect on serum and tissue lipids in experimental diabetes. J Med Food. (2004) 7:472-6.
  8. Olaleye MT, Akinmoladun AC, Ogunboye AA, Akindahunsi AA. Antioxidant activity and hepatoprotective property of leaf extracts of Boerhaavia diffusa Linn against acetaminophen-induced liver damage in rats. Food Chem Toxicol. (2010) 48:2200-5. doi: 10.1016/j.fct.2010.05.047. Epub 2010 May 27. PMID: 20553784.
  9. Kamanna VS, Chandrasekhara N. Effect of garlic (Allium sativum linn) on serum lipoproteins and lipoprotein cholesterol levels in albino rats rendered hypercholesteremic by feeding cholesterol. Lipids. (1982) 17:483-8. doi: 10.1007/BF02535329. PMID: 7121209.
  10. Bordia A, Verma SK, Srivastava KC. Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease. Prostaglandins Leukot Essent Fatty Acids. (1998) 58:257-63. doi: 10.1016/s0952-3278(98)90034-5. PMID: 9654398.
  11. Sobenin IA, Andrianova IV, Lakunin KY, Karagodin VP, Bobryshev YV, Orekhov AN. Anti-atherosclerotic effects of garlic preparation in freeze injury model of atherosclerosis in cholesterol-fed rabbits. Phytomedicine. (2016) 15:1235-9. doi: 10.1016/j.phymed.2015.10.014. Epub 2015 Nov 14. PMID: 26739249.
  12. Hiyasat B, Sabha D, Grotzinger K, Kempfert J, Rauwald JW, Mohr FW, et al Antiplatelet activity of Allium ursinum and Allium sativum. Pharmacology. (2009) 83:197-204. doi: 10.1159/000196811. Epub 2009 Jan 28. PMID: 19174616.
  13. Marx W, McKavanagh D, McCarthy AL, Bird R, Ried K, Chan A, Isenring L. The effect of ginger (Zingiber officinale) on platelet aggregation: a systematic literature review. PloS one. (2015) 10:e0141119.
  14. Salih AK, Alwan AH, Khadim M, Al-Qaim ZH, Mardanov B, El-Sehrwy AA, et al Effect of ginger (Zingiber officinale) intake on human serum lipid profile: Systematic review and meta-analysis. Phytother Res. (2023) 37:2472 2483.
  15. Ramachandran S, Asokkumar K, Uma Maheswari M, Ravi TK, Sivashanmugam AT, Saravanan S, et al Investigation of Antidiabetic, Antihyperlipidemic, and In Vivo Antioxidant Properties of Sphaeranthus indicus Linn. in Type 1 Diabetic Rats: An Identification of Possible Biomarkers. Evid Based Complement Alternat Med. (2011) 2011:571721.
  16. Brown JC, Gerhardt TE, Kwon E. Risk Factors for Coronary Artery Disease. (2023) Jan 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 PMID: 32119297.
  17. Khalid K, Padda J, Ismail D, Abdullah M, Gupta D, Pradeep R, et al Correlation of Coronary Artery Disease and Left Ventricular Hypertrophy. Cureus. (2021) 13:e17550.
  18. Kumar AS, Sinha N. Cardiovascular disease in India: A 360 degree overview. Med J Armed Forces India. (2020) 76:1-3. https://doi.org/10.1016/j.mjafi.2019.12.005.
  19. Yuan H, Ma Q, Ye L, Piao G. The traditional medicine and modern medicine from natural products. Molecules. (2016) 21:559. https://doi.org/10.3390/molecules21050559.
  20. Nishteswar K. Credential evidences of Ayurvedic cardio-vascular herbs. Ayu. (2014). 35, 111–112. https://doi.org/10.4103/0974-8520.146194.
  21. Waltenberger B, Mocan A, Šmejkal K, Heiss EH, Atanasov AG. Natural products to counteract the epidemic of cardiovascular and metabolic disorders. Molecules. (2016) 21(6):807.
  22. Liang B, Gu N. Traditional Chinese medicine for coronary artery disease treatment: clinical evidence from randomized controlled trials. Front Cardiovasc Med. (2021) 8:702110.
  23. Naghavi MWHL. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. (2017) 390:1151–210.
  24. Zhu KF, Wang YM, Zhu JZ, Zhou QY, Wang NF. National prevalence of coronary heart disease and its relationship with human development index: a systematic review. Eur J Prev Cardiol. (2016) 23:530–43.
  25. Hajar R. Risk Factors for Coronary Artery Disease: Historical Perspectives. Heart Views. (2017) 18:109-114. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_106_17. PMID: 29184622; PMCID: PMC5686931.
  26. Bauersachs R, Zeymer U, Brière JB, Marre C, Bowrin K, Huelsebeck M. Burden of coronary artery disease and peripheral artery disease: a literature review. Cardiovasc Ther. (2019) doi: 10.1155/2019/8295054. PMID: 32099582; PMCID: PMC7024142.
  27. Li M, Yun W, Wang G, Li A, Gao J,He Q. Roles and mechanisms of garlic and its extracts on atherosclerosis: A review. Front. Pharmacol. (2022) 13:954938
  28. Rahsepar AA, Arbab-Zadeh A. Cardiac CT vs. stress testing in patients with suspected coronary artery disease: review and expert recommendations. Curr Cardiovasc Imaging Rep. (2015) 8:1-1. doi: 10.1007/s12410-015-9344-y. Epub 2015 Jun 17. PMID: 26500716; PMCID: PMC4613789.
  29. Bruning RS, Sturek M. Benefits of exercise training on coronary blood flow in coronary artery disease patients. Prog Cardiovasc Dis. (2015) 57:443-53. doi: 10.1016/j.pcad.2014.10.006. Epub 2014 Nov 6. PMID: 25446554; PMCID: PMC4366344.
  30. Vilcant V, Zeltser R. Treadmill Stress Testing. Treasure Island, FL: StatPearls Publishing (2021).
  31. Burki NK, Lee LY. Mechanisms of dyspnea. Chest. (2010) 138:1196-201. doi: 10.1378/chest.10-0534. PMID: 21051395; PMCID: PMC2972628.
  32. Berliner D, Schneider N, Welte T, Bauersachs J. The Differential Diagnosis of Dyspnea. Dtsch Arztebl Int. (2016) 113:834-845. doi: 10.3238/arztebl.2016.0834. PMID: 28098068; PMCID: PMC5247680.
  33. Montero-Pérez FJ, Quero-Espinosa FB, Clemente-Millán MJ, Castro-Giménez JA, de Burgos-Marín J, Romero-Moreno MÁ. Diagnostic validity of hand gestures in chest pain of coronary origin. Rev Clin Esp (Barc). (2017) 217:252-259. doi: 10.1016/j.rce.2017.02.019. Epub 2017 Apr 11. PMID: 28410822.
  34. Haasenritter J, Stanze D, Widera G, Wilimzig C, Abu Hani M, Sonnichsen AC, et al Does the patient with chest pain have a coronary heart disease? Diagnostic value of single symptoms and signs--a meta-analysis. Croat Med J. (2012) 53:432-41. doi: 10.3325/cmj.2012.53.432. PMID: 23100205; PMCID: PMC3490454.
  35. Huffman JC, Pollack MH, Stern TA. Panic disorder and chest pain: mechanisms, morbidity, and management. Prim Care Companion J Clin Psychiatry. (2002) 4:54.
  36. Andrikopoulos GK, Pastromas S, Tzeis S. Flecainide: Current status and perspectives in arrhythmia management. World J Cardiol. (2015) 7:76-85. doi: 10.4330/wjc.v7.i2.76. PMID: 25717355; PMCID: PMC4325304.
  37. Khadka S, Joshi R, Shrestha DB, Shah D, Bhandari N, Maharjan M, et al Amlodipine-Induced Pedal Edema and Its Relation to Other Variables in Patients at a Tertiary Level Hospital of Kathmandu, Nepal. J Pharm Technol. (2019) 35:51-55. doi: 10.1177/8755122518809005. Epub 2018 Oct 31. PMID: 34861024; PMCID: PMC6383103.
  38. Ginter E, Simko V. Garlic (Allium sativum L.) and cardiovascular diseases. Bratisl Lek Listy. (2010) 111:452-6. PMID: 21033626.
  39. El-Saber Batiha G, Magdy Beshbishy A, Wasef LG, Elewa YH, Al-Sagan AA, El-Hack A, et al Chemical constituents and pharmacological activities of garlic (Allium sativum L.): A review. Nutrients. (2020) 12, 872.
  40. Sun YE, Wang W, Qin J. Anti-hyperlipidemia of garlic by reducing the level of total cholesterol and low-density lipoprotein: A meta-analysis. Medicine. (2018) 97:e0255. doi: 10.1097/MD.0000000000010255. PMID: 29718835; PMCID: PMC6392629.
  41. Aslani N, Entezari MH, Askari G, Maghsoudi Z, Maracy MR. Effect of Garlic and Lemon Juice Mixture on Lipid Profile and Some Cardiovascular Risk Factors in People 30-60 Years Old with Moderate Hyperlipidaemia: A Randomized Clinical Trial. Int J Prev Med. (2016) 7:95. doi: 10.4103/2008-7802.187248. PMID: 27563431; PMCID: PMC4977979.
  42. Kheirmandparizi M, Keshavarz P, Nowrouzi-Sohrabi P, Hosseini-Bensenjan M, Rezaei S, Kashani SMA, et al Effects of garlic extract on lipid profile in patients with coronary artery disease: A systematic review and meta-analysis of randomised clinical trials. Int J Clin Pract. (2021) 75:e14974. doi: 10.1111/ijcp.14974. Epub 2021 Nov 18. PMID: 34627133.
  43. Bayan L, Koulivand PH, Gorji A. Garlic: a review of potential therapeutic effects. Avicenna J Phytomed. (2014) 4:1-14. PMID: 25050296; PMCID: PMC4103721.
  44. Franczyk B, Rysz J, Ławiński J, Rysz-Górzyńska M, Gluba-Brzózka A. Is a High HDL-Cholesterol Level Always Beneficial? Biomedicines. (2021) 9:1083. doi: 10.3390/biomedicines9091083. PMID: 34572269; PMCID: PMC8466913.
  45. Jayan S, Deepa. Effect of Erandapathrakshara (Ricinus Communis Linn.) along with Hingu (Ferula Narthex Linn.) in Dyslipidemia. Int. J. Ayur. Pharma Research. (2017) 5:51-55.
  46. Salih AK, Alwan AH, Khadim M, Al-Qaim ZH, Mardanov B, El-Sehrwy AA, et al Effect of ginger (Zingiber officinale) intake on human serum lipid profile: Systematic review and meta-analysis. Phytother Res. (2023) 37:2472-2483. doi: 10.1002/ptr.7769. Epub 2023 Feb 14. PMID: 36786398.
  47. Alizadeh-Navaei R, Roozbeh F, Saravi M, Pouramir M, Jalali F, Moghadamnia AA. Investigation of the effect of ginger on the lipid levels. Saudi Med J. (2008) 29:1280-4.
  48. Ramachandran S. Review on Sphaeranthus indicus Linn. (Koṭṭaikkarantai). Pharmacogn Rev. (2013) 7:157-69. doi: 10.4103/0973-7847.120517. PMID: 24347924; PMCID: PMC3841994.
  49. Iftikhar A, Aslam B, Iftikhar M, Majeed W, Batool M, Zahoor B, et al Effect of Caesalpinia bonduc Polyphenol Extract on Alloxan-Induced Diabetic Rats in Attenuating Hyperglycemia by Upregulating Insulin Secretion and Inhibiting JNK Signaling Pathway. Oxid Med Cell Longev. (2020) 2020:9020219. doi: 10.1155/2020/9020219. PMID: 32256963; PMCID: PMC7103044.
  50. Ried K. Garlic lowers blood pressure in hypertensive subjects, improves arterial stiffness and gut microbiota: A review and meta-analysis. Exp Ther Med. 2020 19:1472-1478. doi: 10.3892/etm.2019.8374. Epub 2019 Dec 27. PMID: 32010325; PMCID: PMC6966103.
  51. Hasani H, Arab A, Hadi A, Pourmasoumi M, Ghavami A, Miraghajani M. Does ginger supplementation lower blood pressure? A systematic review and meta-analysis of clinical trials. Phytother Res. (2019) 33:1639-1647. doi: 10.1002/ptr.6362. Epub 2019 Apr 11. PMID: 30972845.
  52. Galani VJ, Patel BG, Rana DG. Sphaeranthus indicus Linn.: A phytopharmacological review. Int J Ayurveda Res. (2010) 1:247-53.
  53. Ren Y, Patel K, Crane T. A review of antiplatelet drugs, coronary artery diseases and cardiopulmonary bypass. J Extra Corpor Technol. (2010) 42:103-13. PMID: 20648894; PMCID: PMC4680033.
  54. Kasthuri Nair A, Pratap A, Miharjan K, Jishnu R, Lekshmi R. The effect of lasunairandadi kashaya in managing coronary artery disease as an add on therapy: A Case Study. Int. J. Res. Ayurveda Pharm. (2019) 10:86-89
  55. Diab A, Dastmalchi LN, Gulati M, Michos ED. A Heart-Healthy Diet for Cardiovascular Disease Prevention: Where Are We Now? Vasc Health Risk Manag. (2023) 19:237-253. doi: 10.2147/VHRM.S379874. PMID: 37113563; PMCID: PMC10128075.
  56. Shaw LJ, Peterson ED, Shaw LK, Kesler KL, DeLong ER, Harrell Jr FE, et al Use of a prognostic treadmill score in identifying diagnostic coronary disease subgroups. Circulation. (1998) 98:1622-30. doi: 10.1161/01.cir.98.16.1622. PMID: 9778327.
Iranian Heart Journal
Volume 26, Issue 1
Winter 2025
Pages 35-53