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Effect of Ginkgolide in Ischemic Stroke patients with large Artery Atherosclerosis: Results from a randomized trial
- Source :
- CNS Neuroscience & Therapeutics
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Background Dual antiplatelet therapy is considered beneficial in acute ischemic stroke (AIS) patients with intracranial artery stenosis (ICAS), with more bleeding events. Ginkgolide is shown to reduce platelet activation after infarction, which might be of benefit in AIS. We aimed to explore the effect of Ginkgolide in AIS patients with ICAS. Methods This was a randomized, double‐blinded, placebo‐controlled trial conducted at 61 centers in China. Within 72 h after onset, consecutive patients diagnosed as AIS with ICAS were randomized to either Ginkgolide or placebo treatment. The primary outcome was the composite of mortality and recurrent stroke (ischemic or hemorrhagic) during first 4 weeks in an intention‐to‐treat analysis. Secondary functional outcome was assessed by modified Rankin Scale and improvement of stroke severity was assessed by National Institution of Health Stroke Scale at day 28. Safety outcome was measured by the rate of severe adverse event (SAE). Results There were 936 patients randomized to either Ginkgolide or placebo treatment. Their average age was 64.2 ± 10.4 years old and 36.0% of the patients were female. The composite index event occurred in six patients in placebo group, and none occurred in Ginkgolide group (risk ratio 1.01; 95% CI 1.00–1.02). There were more patients who achieved favorable outcome in Ginkgolide group, compared with that of the placebo group (OR 2.16, 95%CI 1.37–3.41). SAE occurred in five (1.1%) patients in the Ginkgolide group and three (0.6%) in the placebo group (OR0.60, 95CI% 0.14–2.53). Intracranial hemorrhage occurred in 1/473 (0.2%) in the placebo group. Conclusions Ginkgolide, working as PAF antagonist, may reduce recurrent stroke in AIS with ICAS patients within 72 hours after onset. It might be an optional treatment in moderate‐to‐severe AIS patients with ICAS. (http://www.chictr.org.cn Number as ChiCTR‐IPR‐17012310).<br />Although dual antiplatelet therapy is considered benefit in acute ischemic stroke (AIS) patients with intracranial artery stenosis (ICAS), there are more bleeding events. Ginkgolide, works as PAF antagonist, may reduce recurrent and mortality in AIS with large artery stenosis within 72 hours atfer onset during 90 days follow‐up. It might play a role of neuroprotection in AIS patients with ICAS
- Subjects :
- Male
acute ischemic stroke
medicine.medical_specialty
Infarction
law.invention
chemistry.chemical_compound
Double-Blind Method
Randomized controlled trial
law
Modified Rankin Scale
Physiology (medical)
Internal medicine
Outcome Assessment, Health Care
medicine
Humans
Pharmacology (medical)
Platelet activation
Adverse effect
Aged
Ischemic Stroke
Pharmacology
business.industry
PAF
ginkgolide
Original Articles
Middle Aged
Atherosclerosis
medicine.disease
Psychiatry and Mental health
Stenosis
Ginkgolides
chemistry
Relative risk
Ginkgolide
intracranial stenosis
Female
Original Article
Cerebral Arterial Diseases
business
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 17555949 and 17555930
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- CNS Neuroscience & Therapeutics
- Accession number :
- edsair.doi.dedup.....ca4051c7e4ba5ad9bdd16a0f6a27f77c