**1. Introduction**

Cardiovascular diseases (CVDs: acute myocardial infarction, cerebrovascular disease, and peripheral arterial thrombosis) are responsible for approximately 30% of deaths worldwide [1,2]. Platelets play a relevant role in the atherosclerotic process in physiopathologic and thrombotic events. It has been observed that some bioactive compounds present in fruits and vegetables, when consumed regularly, can inhibit platelet aggregation and thus reduce the risk of CVD [3].

Epidemiological studies have shown that modifiable cardiovascular risk factors (CVRFs) increase the probability of suffering from CVD [4]. There are non-modifiable factors such as

**Citation:** Rodríguez, L.; Trostchansky, A.; Vogel, H.; Wood, I.; Palomo, I.; Wehinger, S.; Fuentes, E. A Comprehensive Literature Review on Cardioprotective Effects of Bioactive Compounds Present in Fruits of *Aristotelia chilensis* Stuntz (Maqui). *Molecules* **2022**, *27*, 6147. https:// doi.org/10.3390/molecules27196147

Academic Editor: Nour Eddine Es-Safi

Received: 21 August 2022 Accepted: 13 September 2022 Published: 20 September 2022

**Publisher's Note:** MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

age and genetic predisposition in addition to modifiable CVRFs such as smoking, dyslipidemias, hypertension, diabetes, metabolic syndrome, and overweight/obesity [5–7]. It has been previously described how inflammation and thrombosis are involved in the onset and progression of non-communicable diseases [8].

Modifications in the population's lifestyle have effects on CVD. Consuming a healthy diet, rich in fruit and vegetables, with high concentrations of proven bioactive protective and antioxidant compounds, has shown to be a promising action in the prevention of CVD [9,10]. Diet and lifestyle are modifiable risk factors that can have a significant impact on an individual's likelihood of developing non-communicable diseases. It has become clear that a person's nutritional status is an important factor in preparing the immune system to deal with any disease [8].

The ethnomedicinal use of natural products and their natural bioactive compounds has increased for the treatment and prevention of CVD [11]. The traditional Mediterranean diet, as well as medicinal plants, have also been reported to exert cardioprotective and antiplatelet effects in the primary and secondary prevention of CVD [12]. According to estimates by the World Health Organization (WHO), approximately 80% of the world's population uses traditional medicinal herbs for their primary health care. Additionally, the consumption of berries, for example, chokeberries (*Aronia melanocarpa*), blueberries (*Vaccinium sect. Oxycoccus*), sea buckthorn berries (*Hippophae rhamnoides*), and grapes (*Vitis*), as well as their various derivative commercial drugs, has been linked to the prevention of CVD, such as atherosclerosis in elderly men [13].

Foods, fruits, vegetables, grains, and fermented beverages such as wine and beer, with antithrombotic and anti-inflammatory properties, contain a large number of phytochemicals such as phenolic compounds, carotenes, alkaloids, terpenes, peptides, and bioactive lipid molecules. Many of these compounds exhibit potent inhibition or modulation of several key proinflammatory and prothrombotic mediator signaling pathways, such as platelet-activating factor (PAF), thrombin, collagen, ADP, arachidonic acid, and related eicosanoids [8]. It has been described that the modulation of the intracellular oxidative state through the consumption of antioxidants in the diet could be a promising approach to reducing the risk of CVD [14].

Polyphenols are distinct in the Mediterranean diet because they can modulate platelet function through different mechanisms of action, e.g., modulating thromboxane formation. It is well known that phenolic compounds are the main components of many plants, and have gained increasing public and scientific interest due to their beneficial effects on health as antioxidants [14]. Therefore, plants with high polyphenol content and antioxidant activity are worth studying. In this group of plants of great interest, we have *Aristotelia chilensis* (Stuntz) also known as Maqui, which is a plant native to Chile, a member of the family Eleocarpaceae, which is distributed across the world in tropical and temperate areas of Asia, Oceania, and South America. Maqui has stood out for the presence of phenolic compounds and its anticancer, antimutagenic, anti-inflammatory, and antioxidant activities. Although some authors have discussed Maqui's cardioprotective activity, there exist few studies linking this berry with an antiplatelet effect.
