Does Ginkgo biloba reduce the risk of cardiovascular events?
BACKGROUND
Cardiovascular disease (CVD) was a preplanned secondary outcome of the Ginkgo Evaluation of Memory Study. The trial previously reported that Ginkgo biloba had no effect on the primary outcome, incident dementia.


RESULTS
The double-blind trial randomly assigned 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 sex. 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 events, 12 (0.8%) on G biloba and 23 (1.5%) on placebo (P=0.04, exact test). Most of the peripheral vascular disease cases had either vascular surgery or amputation.


CONCLUSIONS
There was no evidence that G biloba reduced total or CVD mortality or CVD events. There were more peripheral vascular disease events in the placebo arm. G biloba cannot be recommended for preventing CVD. Further clinical trials of peripheral vascular disease outcomes might be indicated.


BACKGROUND
clinicaltrials.gov Identifier: NCT00010803.
Kuller
Lewis H
LH
Department of Epidemiology, University of Pittsburgh, 130 N Bellefield Ave, Room 550, Pittsburgh, PA 15213, USA. kullerl@edc.pitt.edu
Ives
Diane G
DG
Fitzpatrick
Annette L
AL
Carlson
Michelle C
MC
Mercado
Carla
C
Lopez
Oscar L
OL
Burke
Gregory L
GL
Furberg
Curt D
CD
DeKosky
Steven T
ST
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D004311:Double-Blind Method; D019317:Evidence-Based Medicine; D005260:Female; D020441:Ginkgo biloba; D006760:Hospitalization; D006801:Humans; D008297:Male; D010936:Plant Extracts / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D000096983:Ginkgo Extract
D002317:Cardiovascular Agents; D010936:Plant Extracts; C063170:Ginkgo biloba extract; D000096983:Ginkgo Extract