Effects of Royal Jelly and Propolis on Metabolomic Signatures, Inflammation, and Cardiovascular Risk in Patients With Coronary Artery Disease.

Several sources of bioactive compounds have been studied due to their protective effect against coronary artery disease (CAD), mainly by modulating inflammation and oxidative stress. Among them, propolis stands out, rich in flavonoids and phenolic acids, which exhibits antioxidant and anti-inflammatory activity; and royal jelly, containing bioactive peptides that promote endothelial function and have an anti-inflammatory effect, potentially contributing to the prevention of CAD progression. Regular consumption of these foods may represent a complementary therapeutic strategy for CAD prevention.

• Propolis + Royal Jelly (Dietary supplement): They will receive 4 capsules per day, providing 300 mg of royal jelly per day and 500 mg of propolis per day.
• Placebo (Dietary supplement): They will receive 4 capsules per day, providing daily delivery of the active formulation vehicle (microcrystalline cellulose and magnesium stearate in colored gelatin capsules capable of masking the appearance of the internal contents).

Primary outcomes

• Change of inflammatory status in the participants [Baseline and 8 weeks]: Get blood samples to evaluate the supplementation effects in inflammatory biomarkers: interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), C-reactive protein (CRP).

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Both sexes
* Over 18 years of age;
* Diagnosed with Coronary Artery Disease: confirmed by coronary angiography, coronary computed tomography angiography, or functional testing with ischemic load);
* Participants who are asymptomatic or have angina limited to functional class III will be considered;
* Patients who have already undergone coronary revascularization and angioplasty may participate;
* the last acute coronary event must have occurred more than one year ago.

Exclusion Criteria:

* Unstable Coronary Artery Disease;
* Pre-operative coronary artery bypass grafting or awaiting elective angioplasty;
* Unstable angina;
* NYHA functional class III or higher;
* Advanced chronic kidney disease (creatinine clearance < 30 ml/min/1.73 m²);
* Individuals with autoimmune diseases.

• Ludmila Cardozo, Principal investigator, Universidade Federal Fluminense