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The SELECT trial demonstrated cardiovascular benefit in patients with established heart disease, showing approximately 20% reduction in major adverse cardiovascular events
One proposed intracellular pathway involves the enzyme adenylyl cyclase, which is hypothesized to convert adenosine triphosphate (ATP) into cyclic adenosine monophosphate (cAMP)
It upregulates genes involved in collagen synthesis (COL1A1, COL3A1, COL5A1), extracellular matrix remodeling (decorin, fibromodulin), and antioxidant defense (superoxide dismutase, glutathione peroxidase) while simultaneously suppressing genes associated with inflammation (IL-6, TNF-alpha), fibrinogen production, and tissue destruction (several MMPs)
Baig et al
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