Efficacy and Safety of Vinpocetine as Part of Treatment for Acute Cerebral Infarction: A Randomized, Open-Label, Controlled, Multicenter CAVIN (Chinese Assessment for Vinpocetine in Neurology) Trial.
OBJECTIVE
The objective of this study was to evaluate the efficacy and safety of intravenous vinpocetine administration as part of a comprehensive treatment for acute cerebral infarction in a Chinese population.


METHODS
610 acute cerebral infarction patients were randomized into two groups: the vinpocetine group (469 patients) received cytidine disphosphate choline 0.4-0.5 g in combination with aspirin 75-100 mg or clopidogrel 75 mg once daily, plus vinpocetine 30 mg intravenously once daily for 7 days, while the control group (141 patients) received cytidine disphosphate choline 0.4-0.5 g in combination with aspirin 75-100 mg or clopidogrel 75 mg once daily for 7 days. Additionally, patients received medications for symptoms such as hypertension, hyperglycemia, hyperlipidemia, and intracranial hypertension when necessary. Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale, and Barthel Index (BI) scores and transcranial doppler (TCD) were assessed at baseline, 7, 14, and 90 days after treatment. Adverse events (AEs) and abnormalities in blood, urine, liver, and kidney function were monitored.


RESULTS
MMSE, NIHSS, and BI scores were significantly higher in the vinpocetine group than in the control group 90 days after treatment, indicating significantly improved cognitive skill, neurological function, and quality of life (QOL) in the vinpocetine group versus the control group. Importantly, such effects of vinpocetine were maintained over time. In addition, TCD monitoring showed significantly increased cerebral blood flow associated with vinpocetine versus control. No significant difference in safety was noted between the two groups.


CONCLUSIONS
When used as part of treatment for acute cerebral infarction, vinpocetine improves patients' cerebral blood flow, cognitive quality, neurological functions, and QOL. Vinpocetine could be an effective and safe component of treatment regimen for acute cerebral infarction.
Department of Neurology, Beijing Military General Hospital, Nanmencang #5, Dongsi Street, Beijing, 100700, China. weiweizhangbeijing@163.com.
Weiwei
W
Zhang
Peking University First Hospital, No. 8 Xishiku St, Xicheng District, Beijing, 100034, China.
Yining
Y
Huang
Department of Neurology, Beijing Military General Hospital, Nanmencang #5, Dongsi Street, Beijing, 100700, China.
Ying
Y
Li
The Second Xiangya Hospital of Central South University, No. 139 Renmin Rd (Mid), Changsha, Hunan, China.
Liming
L
Tan
Shengjing Hospital of China Medical University, No. 36 Sanhao St, Heping District, Shenyang, 110004, Liaoning, China.
Jianfei
J
Nao
Beijing Jishuitan Hospital, No. 31 East St, Xijiekou, Xicheng District, Beijing, 100035, China.
Hongtao
H
Hu
The Fourth Hospital of Harbin Medical University, No. 37 Yuyuan St, Nangang District, Harbin, 150001, Heilongjiang, China.
Jingyu
J
Zhang
Tianjin Fifth Central Hospital, No. 41 Zhejiang Rd, Tanggu District, Tianjin, 300450, China.
Chen
C
Li
Wuxi No. 2 People's Hospital, No. 68 Zhongshan Rd, Wuxi, 214002, Jiangsu, China.
Yuenan
Y
Kong
Anshan Changda Hospital, No. 69, Changda St, Teidong District, Anshan, Liaoning, China.
Yulin
Y
Song
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000523:psychology; D002560:Cerebrovascular Circulation / Q000187:drug effects; D002681:China; D000077144:Clopidogrel; D003071:Cognition / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011788:Quality of Life; D020521:Stroke / Q000517:prevention & control; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D017585:Ultrasonography, Doppler, Transcranial; D014748:Vinca Alkaloids / Q000009:adverse effects / Q000627:therapeutic use*
D000925:Anticoagulants; D018696:Neuroprotective Agents; D010975:Platelet Aggregation Inhibitors; D014748:Vinca Alkaloids; C013983:vinpocetine; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin