Does Ginkgo biloba reduce the risk of cardiovascular events?
Does Ginkgo biloba reduce the risk of cardiovascular events?
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DOI：
10.1161/circoutcomes.109.871640
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发表时间：
2010-01
期刊：
影响因子：
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通讯作者：
Ginkgo Evaluation of Memory Study Investigators
中科院分区：
文献类型：
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作者：
Kuller LH;Ives DG;Fitzpatrick AL;Carlson MC;Mercado C;Lopez OL;Burke GL;Furberg CD;DeKosky ST;Ginkgo Evaluation of Memory Study Investigators
心血管疾病（CVD）是银杏记忆评估（GEM）研究的一个预先计划的次要结局。该试验先前报道，银杏叶（G. biloba）对主要结局（痴呆事件）没有影响。这项双盲试验将3069名75岁以上的参与者随机分组，每天两次服用120毫克G. biloba EGb 761或安慰剂。平均随访6.1年。CVD的识别和分类是基于心血管健康研究中使用的方法。采用Cox比例风险回归对年龄和性别进行校正，评估双叶烟叶和安慰剂在事件发生时间上的差异。研究中有355人死亡，其中87人死于冠心病，与安慰剂相比没有差异。在心肌梗死（n=164）、心绞痛（n=207）和中风（151）的发生率上，双叶薄荷组和安慰剂组没有差异。有24例出血性中风，16例服用双叶葛兰，8例服用安慰剂（无统计学意义）。外周血管疾病（PVD）事件仅35例，双叶菌组12例（0.8%），安慰剂组23例（1.5%）（p=0.04）。大多数PVD病例都进行了血管手术或截肢。没有证据表明双歧杆菌降低了总死亡率或心血管疾病死亡率或心血管疾病事件。安慰剂组有更多的PVD事件。不推荐双叶烟叶用于预防心血管疾病。可能需要对PVD结果进行进一步的临床试验。
Cardiovascular disease (CVD) was a preplanned secondary outcome of the Ginkgo Evaluation of Memory (GEM) Study. The trial previously reported that Ginkgo biloba (G. biloba) had no effect on the primary outcome, incident dementia. The double-blind trial randomized 3069 participants over 75 years of age to 120 mg of G. biloba EGb 761 twice daily or placebo. Mean follow up was 6.1 years. The identification and classification of CVD was based on methods used in the Cardiovascular Health Study. Differences in time to event between G. biloba and placebo were evaluated using Cox proportional hazards regression adjusted for age and gender. There were 355 deaths in the study, 87 due to coronary heart disease with no differences between G. biloba and placebo. There were no differences in incident myocardial infarction (n=164), angina pectoris (n=207) or stroke (151) between G. biloba and placebo. There were 24 hemorrhagic strokes, 16 on G. biloba and 8 on placebo (not significant). There were only 35 peripheral vascular disease (PVD) events, 12 (0.8%) on G. biloba and 23 (1.5%) on placebo (p=0.04 exact test). Most of the PVD cases had either vascular surgery or amputation. There was no evidence that G. biloba reduced total or CVD mortality or CVD events. There were more PVD events in the placebo arm. G. biloba cannot be recommended for preventing CVD. Further clinical trials of PVD outcomes might be indicated.