The Clinical Effect Of Ginkgo Leaf Extract And Dipyridamole Injection Combined With Intravenous Thrombolytic Therapy On Patients With Acute Myocardial Infarction

Objective To investigate the clinical effect of Ginkgo Leaf Extract and Dipyridamole Injection combined with intravenous thrombolytic therapy on inpatients with acute myo- cardial infarction. Primarily evaluate the influence of Ginkgo Leaf Extract and Dipyridamole Injection on microcirculation reperfusion of AMI after thrombolysis. Methods The AMI inpatients treated with intravenous thrombolysis in the Ist affiliated hospital of Guangzhou Universityof Traditional Chinese Medicine from May 2005 to Feb. 2007 was collected for prospective study. The trial divided an overall enrollment of 48 eligible patients into contrast group (22 cases) and injection of Ginkgo Leaf Extract group (28 cases) at random. The contrast group was only treated with standardized thrombolysis, while the injection of Ginkgo Leaf Extract group was given intravenous injection of Ginkgo Leaf Extract and Dipyridamole (put this injection 20ml into 0.9% N.S 250mi ivdrip qd, treatment period 2 weeks) before standardized thrombolytic therapy. The primary trial endpoint was the clinical effect of the injection after 2 weeks. Continuously recorded the 18-lead elctrocardiogram before and 2 hours after thrombolysis per 30min,CK and CK—MB until 16 hour after onset of AMI per 2 hours,the 2nd day as well as the 3rd day respectively,the EF values. And then calculated the rate ofΣSTI(ST index)back≥50 % within 2 hours after thrombolysis and the area below CK—MB curve. In addition, the compound clinical events should be on record. Results The group of Ginkgo Leaf Extract injection had significantly superior patency rates to the contrast group (96.2% VS 77.3%, P=0.049). Furthermore, the group of Ginkgo Leaf Extract injection received significantly higher the rate ofΣSTIback≥50 % within 2 hours afterthrombolysisthanthecontrastgroup(76.9% VS63.6%, P=0.313), and the CK-MB,CK peak value was significantly less in the group of Ginkgo Leaf Extract injection compared with the contrast group (241.3±108.6 VS 315.5±124.6, P=0.037)and(2309.9±1024.3 VS 2986.5±1156.9 P=0.043). The EF value and the incidence of compound clinical events within 2 weeks after thrombolysis were significantly different between the group of Ginkgo Leaf Extract injection and the contrast group (52.53%±5.66% VS 46.67%±8.86%, P=0.011) and(19.2 % VS 45.5 %, P= 0.049). However, the overall bleeding incidence occurred mainly at the scale of mild bleeding was no significantly difference between two groups(19.2% VS 18.2%, P =0.926) and no hemorrhage stroke,serious hemorrhage and allergic reaction happened for both groups. Conclusion The clinical effect of Ginkgo Leaf Extract and Dipyridamole Injection combined with intravenous thrombolytic therapy on inpatients with acute myocardial infarction is singnifcant and safety. The improvement of myocardial microcirculation reperfusion is the main mechanism.