From the Research
There is currently no scientific evidence to suggest that nattokinase can reduce a high coronary artery calcium score (CACS). Nattokinase, an enzyme derived from fermented soybeans (natto), has shown some fibrinolytic and anticoagulant properties in laboratory studies, but its effects on calcium deposits in coronary arteries have not been demonstrated in rigorous clinical trials 1. Coronary artery calcium is a marker of atherosclerosis that develops over many years and represents calcified plaque in the arteries. Established approaches to potentially slow progression of coronary calcium include statin medications, blood pressure control, smoking cessation, regular exercise, and dietary modifications. These evidence-based interventions target the underlying causes of atherosclerosis by reducing inflammation and improving lipid profiles.
Some studies have investigated the effects of nattokinase on cardiovascular health, including a study published in 2017 that found nattokinase supplementation reduced carotid artery intimal medial thickness and carotid artery plaque size in patients with hyperlipidemia 2. However, this study did not specifically examine the effect of nattokinase on coronary artery calcium scores. Another study published in 2024 reviewed the potential effects of nattokinase on mitigating inflammation and oxidative stress in non-communicable diseases, including cardiovascular disease 1. While these studies suggest potential benefits of nattokinase for cardiovascular health, they do not provide evidence for its effectiveness in reducing coronary artery calcium scores.
While some people take nattokinase supplements for cardiovascular health, typically at doses of 100-200 mg daily, there is insufficient evidence to recommend it specifically for reducing calcium scores. Anyone concerned about a high CACS should work with their healthcare provider to implement proven risk-reduction strategies rather than relying on supplements with unproven benefits for this specific condition. Other studies have focused on the expression and production of nattokinase, such as a 2021 study that expressed nattokinase using a Pichia pastoris heterologous expression system and assessed its thrombolytic activity 3, and a 2023 study that improved the fibrinolytic activity and stability of nattokinase through surface charge engineering 4. Additionally, a 2024 study examined the effect of nattokinase on pathological conditions in streptozotocin-induced diabetic rats and found that high-dose nattokinase inhibited glycogen deposition in renal tubules and reduced advanced glycation end products and C-reactive protein levels 5. However, these studies do not provide evidence for the effectiveness of nattokinase in reducing coronary artery calcium scores.