Skip to content
Winnowleaf home

Condition

Acute Coronary Syndrome (ACS)

Acute coronary syndrome covers heart attacks and unstable angina, which happen when a ruptured plaque and blood clot suddenly cut blood flow in a coronary artery. Among supplements, omega-3 fatty acids have the strongest evidence, followed by coenzyme Q10. A small curcumin trial of 63 people found HDL cholesterol improved, but evidence for creatinol O-phosphate is limited and mostly animal or lab work.

Supplements studied
2
Medicines and peptides
1
Graded outcomes
5
Trials
1
People studied
63

Evidence by supplement

  • Strong
  • Moderate
  • Limited
  • Very limited

2 supplements

Creatinol O-Phosphate

Creatinol O-Phosphate: outcomes studied for Acute Coronary Syndrome (ACS)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Myocardial Ischemia Protection (IV Administration)

A double-blind clinical trial found IV COP improved outcomes in patients with inadequate coronary circulation. Animal studies in rats and mice showed COP protected against isoprenaline-induced cardiac enzyme elevation and CaCl2-induced ventricular fibrillation. An in vitro NMR study in perfused Xenopus heart confirmed effects on cardiac energy metabolism. All evidence is from IV or direct perfusion, not oral dosing.

Improves (the measure goes up)Moderate effect7 studies80 people

Studies that measured myocardial ischemia protection (iv administration)

and 4 more on the Creatinol O-Phosphate page

Curcumin

Curcumin: outcomes studied for Acute Coronary Syndrome (ACS)
GradeOutcomeEffectSizeStudiesPeopleStudies list
High-density lipoprotein (HDL)

Small Improvement

Improves (the measure goes up)Small effect63 people
TriglyceridesImproves (the measure goes down)9 studies63 people

Studies that measured triglycerides

and 6 more on the Curcumin page

Low-density lipoprotein (LDL)Improves (the measure goes down)5 studies63 people

Studies that measured low-density lipoprotein (ldl)

and 2 more on the Curcumin page

Prescription medicines and peptides studied, for context

These are not supplements. Most need a prescription, and some are research compounds with no approved use. They are listed so the supplement evidence above can be read against them.

1 medicine or peptide

Eptifibatide (Integrilin)

  • Death/MI/Refractory Ischemia: improves
  • Major Bleeding: worsens
  • Thrombocytopenia: worsens
Eptifibatide (Integrilin): outcomes studied for Acute Coronary Syndrome (ACS)
GradeOutcomeEffectSizeStudiesPeopleStudies list
Death/MI/Refractory Ischemia

PURSUIT (n=10,948): Composite endpoint 14.2% vs 15.7% placebo at 30 days (P=0.04). 1.5% absolute risk reduction. Benefit apparent by 96 hours. NNT=67 to prevent one event.

Improves (the measure goes down)Small effect21 studies
Major Bleeding

SAFETY CONCERN: ESPRIT: Major bleeding 1.3% vs 0.4% placebo (P=0.027). PURSUIT: 2.1% vs 1.3%. Most bleeding at femoral access sites, mild. No increase in hemorrhagic stroke. ISMP high-risk medication.

Worsens (the measure goes up)Small effect20 studies
Thrombocytopenia

SAFETY CONCERN: Significant thrombocytopenia (<20,000/μL) in 0.2% of patients in ESPRIT. Platelet monitoring recommended. Generally reversible upon discontinuation.

Worsens (the measure goes down)Small effect21 studies

Key findings

  • Myocardial Ischemia Protection (IV Administration)Creatinol O-PhosphateImproves (the measure goes up)
  • High-density lipoprotein (HDL)CurcuminImproves (the measure goes up)

Safety notes in the studies

  • 1.5% absolute risk reduction.
  • ISMP high-risk medication.

The Post-Acute Coronary Syndrome Recovery Support protocol

2 primary supplements · 6 supporting supplements

See the full protocol

Shop the evidence-backed picks

Support alongside medical care. These supplements are not a treatment for Acute Coronary Syndrome (ACS). If you are being treated for it, talk to your clinician before adding one: supplements can interact with medicines.

Fullscript collectionHeart and circulation: evidence-graded picksOpen on Fullscript

We earn from purchases made in our Fullscript store, and links to Fullscript, iHerb or Thorne carry our referral, so we may earn a commission at no extra cost to you. Grades come from the research and never change based on what we earn. Full disclosure

Studies cited

44 studies from PubMed

  1. Eptifibatide as an adjuvant therapy to thrombolysis versus thrombolysis alone in stroke management: a systematic review and meta-analysis of randomized controlled trials.Journal of thrombosis and thrombolysis, 2025 · PMID 40544389
  2. A Double-Blinded Randomized Controlled Trial Comparing Eptifibatide Bolus Only Versus Bolus Plus Infusion In Patients Undergoing Primary Percutaneous Coronary Intervention For ST-Elevation Myocardial Infarction.Cardiovascular revascularization medicine : including molecular interventions, 2023 · PMID 36737382
  3. Thrombocytopenia and Thromboses in Myocardial Infarction Associated with Eptifibatide-Dependent Activating Antiplatelet Antibodies.Thrombosis and haemostasis, 2020 · PMID 32483771
  4. Effects of Crushed Ticagrelor Versus Eptifibatide Bolus Plus Clopidogrel in Troponin-Negative Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention: A Randomized Clinical Trial.Journal of the American Heart Association, 2019 · PMID 31766977
  5. Is eptifibatide a safe and effective rescue therapy in thromboembolic events complicating cerebral aneurysm coil embolization? Single-center experience in 42 cases and review of the literature.Neuroradiology, 2014 · PMID 24281387
  6. Bleeding risk and safety profile related to the use of eptifibatide: a current reviewExpert Opin Drug Saf, 2012 · PMID 22233272
  7. The kinetics of integrilin limited by obesity: a multicenter randomized pharmacokinetic and pharmacodynamic clinical trial.American heart journal, 2011 · PMID 22137072
  8. Effect of different curcuminoid supplement dosages on total in vivo antioxidant capacity and cholesterol levels of healthy human subjectsPhytother Res, 2011 · PMID 21796707
  9. Comparison by meta-analysis of eptifibatide and tirofiban to abciximab in patients with ST-elevation myocardial infarction treated with primary percutaneous coronary intervention.The American journal of cardiology, 2010 · PMID 20598998
  10. Prolonged infusion of eptifibatide as bridge therapy between bare-metal stent insertion and cardiovascular surgery: case report and review of the literature.Pharmacotherapy, 2010 · PMID 20334463
  11. EptifibatideExpert Opin Pharmacother, 2008 · PMID 31082110
  12. Effect of NCB-02, atorvastatin and placebo on endothelial function, oxidative stress and inflammatory markers in patients with type 2 diabetes mellitus: a randomized, parallel-group, placebo-controlled, 8-week studyDrugs R D, 2008 · PMID 18588355
  13. A review of clinical trials with eptifibatide in cardiology.Cardiovascular drug reviews, 2007 · PMID 18078431
  14. Early initiation of eptifibatide in the emergency department before primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: results of the Time to Integrilin Therapy in Acute Myocardial Infarction (TITAN)-TIMI 34 trial.American heart journal, 2006 · PMID 16996831
  15. Eptifibatide: a review of its use in patients with acute coronary syndromes and/or undergoing percutaneous coronary intervention.Drugs, 2005 · PMID 16162023
  16. Eptifibatide: a pharmacoeconomic review of its use in percutaneous coronary intervention and acute coronary syndromes.PharmacoEconomics, 2003 · PMID 12908844
  17. Eptifibatide in percutaneous coronary intervention. A review.Minerva cardioangiologica, 2002 · PMID 12384635
  18. Platelet glycoprotein IIb/IIIa integrin blockade with eptifibatide in coronary stent intervention: the ESPRIT trial: a randomized controlled trialJAMA, 2001 · PMID 11368699
  19. Early percutaneous coronary intervention, platelet inhibition with eptifibatide, and clinical outcomes in patients with acute coronary syndromes. PURSUIT InvestigatorsCirculation, 2000 · PMID 10683348
  20. Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trialLancet, 2000 · PMID 11145489
  21. Eptifibatide: a review of its use in patients with acute coronary syndromes and/or undergoing percutaneous coronary interventionDrugs, 1999 · PMID 10193692
  22. Modifiable risk factors for vascular access site complications in the IMPACT II Trial of angioplasty with versus without eptifibatideJ Am Coll Cardiol, 1998 · PMID 9626829
  23. Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromesN Engl J Med, 1998 · PMID 9705684
  24. Impact of eptifibatide on early ischemic events in acute ischemic coronary syndromes: a review of the IMPACT II trial. Integrilin to Minimize Platelet Aggregation and Coronary Thrombosis.The American journal of cardiology, 1997 · PMID 9291242
  25. Design and methodology of the PURSUIT trial: evaluating eptifibatide for acute ischemic coronary syndromesAm Heart J, 1997 · PMID 9291244
  26. A 31P NMR spectroscopy study of Xenopus laevis heart perfused in vitro with creatinol-O-phosphate, phosphocreatine, adenosine triphosphate, fructose diphosphate and ouabain.Pharmacological Research, 1993 · PMID 8278305
  27. Effects of creatinol O-phosphate on serum enzymes in acute myocardial infarction.Arzneimittel-Forschung, 1979 · PMID 575498
  28. Protective effect of creatinol O-phosphate (COP) on ventricular fibrillation and death induced by intravenous CaCl2 in mice.Arzneimittel-Forschung, 1979 · PMID 575496
  29. Protective action of creatinol O-phosphate against serum CPK activity enhanced by isoprenaline in the rat.Arzneimittel-Forschung, 1979 · PMID 575495
  30. Acute clinical tolerance of creatinol O-phosphate.Arzneimittel-Forschung, 1979 · PMID 575490
  31. Creatinol O-phosphate therapy in patients with inadequate coronary circulation. Double blind clinical trial.Arzneimittel-Forschung, 1979 · PMID 395958
  32. Pharmacological and toxicological properties of creatinol O-phosphate. A review.Arzneimittel-Forschung, 1979 · PMID 395957
  33. The effect of curcumin on lipid level in patients with acute coronary syndromeActa Med Indones · PMID 19151449
  34. Lipid-modifying effects of adjunctive therapy with curcuminoids-piperine combination in patients with metabolic syndrome: results of a randomized controlled trialComplement Ther Med · PMID 25440375
  35. Effects of Nanocurcumin Supplementation on Metabolic Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Pharmacol Res · PMID 39894187
  36. Curcumin ingestion and exercise training improve vascular endothelial function in postmenopausal womenNutr Res · PMID 23146777
  37. Curcumin effects on blood lipid profile in a 6-month human studyPharmacol Res · PMID 17951067
  38. Effects of supplementation with curcuminoids on dyslipidemia in obese patients: a randomized crossover trialPhytother Res · PMID 22610853
  39. Diverse effects of a low dose supplement of lipidated curcumin in healthy middle aged peopleNutr J · PMID 23013352
  40. Curcuminoids modify lipid profile in type 2 diabetes mellitus: A randomized controlled trialComplement Ther Med · PMID 28735818
  41. Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysisFront Immunol · PMID 36159792
  42. Nano-curcumin improves glucose indices, lipids, inflammation, and Nesfatin in overweight and obese patients with non-alcoholic fatty liver disease (NAFLD): a double-blind randomized placebo-controlled clinical trialNutr Metab · PMID 30705687
  43. Treatment of Non-alcoholic Fatty Liver Disease with Curcumin: A Randomized Placebo-controlled TrialPhytother Res · PMID 27270872
  44. The effects of curcumin supplementation on liver enzymes, lipid profile, glucose homeostasis, and hepatic steatosis and fibrosis in patients with non-alcoholic fatty liver diseaseEur J Clin Nutr · PMID 30610213

Supplement stack for Acute Coronary Syndrome (ACS)