Effects of anthocyanin-rich interventions on platelet function: a systematic review of randomized controlled trials

Anthocyanins, a subclass of dietary flavonoids prevalent in fruits and vegetables, have been linked to a diminished risk of cardiovascular disease (CVD) in epidemiological research. Nonetheless, their precise effects on platelet aggregation, a crucial factor in thrombotic risk, are not fully comprehended. This systematic study sought to assess the effects of anthocyanin-rich diets and supplements on platelet function in adult humans. A comprehensive search of PubMed and Web of Science was performed to identify randomised controlled trials (RCTs) published until July 2024, with a subsequent search in October 2025. English-language RCTs involving adults between the ages of 20 and 65 that reported specific anthocyanin dosage and looked at how anthocyanin treatments affected platelet aggregation were eligible. Study design, demographic characteristics, intervention specifics, and platelet-related outcomes were all extracted. Risk of bias was assessed using the Cochrane RoB 2 tool. Six randomised controlled trials fulfilled the inclusion criteria. Anthocyanin consumption was consistently linked to decreased platelet aggregation produced by adenosine diphosphate (ADP) and collagen in comparison to control interventions. Increased consumption levels (≥ 320 mg/day), especially in extract or juice form, correlated with enhanced benefits, indicating a possible dose–response relationship. Reductions of up to 29% in ADP-induced aggregation and 17% in collagen-induced aggregation were observed. The effects were more significant in metabolically at-risk populations, such as those with overweight/obesity or dyslipidaemia, whereas control groups exhibited minor or no alterations. Current evidence indicates that meals and supplements high in anthocyanins may influence platelet function and decrease thrombotic risk. However, small sample sizes, inconsistent study designs, and variations in anthocyanin formulations and bioavailability restrict the strength of the data. To verify therapeutic relevance and determine the best intake regimens, more carefully planned, sufficiently powered, long-term RCTs including a variety of groups are needed.