Ginkgo Leaf Extract and Dipyridamole Injection as Adjuvant Treatment for Angina Pectoris: A Meta-Analysis of 41 Randomized Controlled Trials

Chin J Integr Med. 2018 Dec;24(12):930-937. doi: 10.1007/s11655-018-2557-6. Epub 2018 May 11.

Abstract

Objective: To provide information about the effectiveness and safety of Ginkgo Leaf Extract and Dipyridamole Injection (GD) as one adjuvant therapy for treating angina pectoris (AP) and to evaluate the relevant randomized controlled trials (RCTs) with meta-analysis.

Methods: RCTs concerning AP treated by GD were searched in China Biology Medicine Disc (SinoMed), PubMed, the China National Knowledge Infrastructure Database (CNKI), the Chinese Scientifific Journals Database (VIP), Wanfang Database, Embase, and the Cochrane Library, from inception to February, 2017. The Cochrane Risk Assessment Tool was adopted to assess the methodological quality of the RCTs. The Review Manager 5.3 software was utilized to conduct the meta-analysis.

Results: A total of 41 RCTs involving 4,462 patients were included in the meta-analysis. The results indicated that the combined use of GD and Western medicine (WM) against AP was associated with a higher total effective rate [risk ratio (RR)=1.25, 95% confifidence interval (CI): 1.21-1.29, P<0.01], total effective rate of electrocardiogram (RR=1.29, 95% CI: 1.21-1.36, P<0.01). Additional, GD combined with WM could decrease the level of plasma viscosity [mean difference (MD)=-0.56, 95% CI:-0,81 to-0.30, P<0.01], fifibrinogen [MD=-1.02, 95% CI:-1.50 to-0.54, P<0.01], whole blood low shear viscosity [MD=-2.27, 95% CI:-3.04 to-1.49, P<0.01], and whole blood high shear viscosity (MD=-0.90, 95% CI: 1.37 to-0.44, P<0.01).

Conclusions: Comparing with receiving WM only, the combine use of GD and WM was associated with a better curative effect for patients with AP. Nevertheless, limited by the methodological quality of included RCTs more large-sample, multi-center RCTs were needed to confifirm our fifindings and provide further evidence for the clinical utility of GD.

Keywords: Ginkgo Leaf Extract and Dipyridamole Injection; angina pectoris; meta-analysis; randomized controlled trials; systematic review.

Publication types

  • Meta-Analysis

MeSH terms

  • Angina Pectoris / drug therapy*
  • Blood Viscosity / drug effects
  • Dipyridamole / administration & dosage*
  • Dipyridamole / adverse effects
  • Drug Combinations
  • Ginkgo biloba
  • Humans
  • Injections
  • Plant Extracts / administration & dosage*
  • Plant Extracts / adverse effects
  • Randomized Controlled Trials as Topic
  • Western World

Substances

  • Drug Combinations
  • Plant Extracts
  • Ginkgo biloba extract
  • Dipyridamole