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INTRODUCTIONGingko Biloba one of the most widely used
plant-based medicinal products primarily for treatment of a
multitude of cognitive deficiencies. Systematic review of eight
RCTs was conducted, examining the effect of GBE on coagulating
factors. Blood coagulation is a clotting mechanism involving a
cascade of reactions in which clotting factors are activated. GBE
has been thought to have a positive effect on blood flow, blood
viscosity, fibrinogen concentration, prothrombin time (PT) and
activated partial thromboplastin time (aPTT) in response to
bleeding. However, research studies showed no conclusive
differences between baseline and treatments, with some showing
insignificant positive results.
ABSTRACTBlood coagulation is a highly regulated pathway
dependent on multiple clotting factors. Gingko Biloba Extract (GBE)
has been believed to reduce blood clot formation. 8 RCTs were
systematically reviewed to examine the impact of GBE on
coagulation. Contrary to belief, results were found to be
inconclusive.DISCUSSIONReview of studies revealed a lack of power
calculations, comparison of dropouts to completers as well as
blinding of patients and outcome assessors, hence failing to
control potential bias.
A possibility for discrepancy between results can be attributed
to lack of significant number of participants in studies.
Furthermore, indicated variation of GB dosage, method of
administration, and diet.
ACKNOWLEDGEMENTS
Special thanks to Dr. Betsy Singh for all your hard work and
dedication towards your students. MATERIALS & METHODS
Pubmed, EBSCOhost, and MedLine databases were searched between
for articles 1980 to 2014. The following keywords were used to
asses outcome parameters of hemostasis: Ginkgo Biloba Extract, GBE
761, coagulation, platelet aggregation, blood flow.
The search of the 3 databases identified 25 unique references.
Of the 25 potentially relevant studies, 10 nonhuman studies and 7
non-RCT studies were eliminated. Our analysis is based on 8 RCTs
chosen for keyword relevance to Ginkgo biloba and blood
coagulation.
RESULTSEight RCTs with a total of 455 individuals of mean age 36
were recruited from all studies. Half of the studies reviewed used
standardized GBE 761 where as the remainder of the studies used
standardized GB doses ranging from 120mg-360mg. Administrations
methods were uncontrolled in 5 out of the 8 studies reviewed. 3
studies ensured that all biases were removed when administering
treatments. 2 of the studies showed a positive correlation between
treatment with GBE and inhibition of platelet aggregation as well
as reduction of blood viscosity respectively. Remainder of studies
showed no significant correlation.
Analysis of RCTs failed to identify any statistically
significant increase in blood flow with GBE compared to baseline
measures and placebo groups. All eight studies showed no
significant increase in blood flow. Effects of Gingko Biloba on
Bleeding Times and Coagulation: A Systematic Review of Randomized
Control Trials (RCTs)Sahin, Emir; Malik, Zamaar; Gomez, Andrew;
Lanka, Padmavati; Elahi, Arooj; Singh, Betsy B.CONCLUSIONIn
summary, all of the studies reviewed showed no significant
difference between baseline measures and treatment groups for
bleeding time and coagulation. No indication of higher bleeding
risk.AuthorTitleTotalKim, BH (2010) Influence of Ginkgo biloba
Extract on the Pharmacodynamic Effects and Pharmacokinetic
Properties of Ticlopidine: An Open-Label, Randomized, Two-Period,
Two-Treatment, Two-Sequence, Single-Dose Crossover Study in Healthy
Korean Male Volunteers19/26Bal dit Sollier, J (2003)No Alteration
in Platelet Function or Coagulation Induced by EGb761 in a
Controlled Study17/26Kudolo, GB (2004)The Ingestion of Ginkgo
biloba Extract (EGb 761) Inhibits Arachidonic Acid-Mediated
Platelet Aggregation20/26Kohler, S (2004) Influence of a 7-Day
Treatment with Ginkgo Biloba Special Extract EGb 761 on Bleeding
Time and Coagulation: A Randomized, Placebo-Controlled,
Double-Blind Study in Healthy Volunteers 22/26Galduro, JCF
(2007)Gender- and Age-Related Variations in Blood Viscosity in
Normal Volunteers: A Study of the Effects of Extract of Allium
Sativum and Ginkgo Biloba19/26Carlson, JJ (2007) Safety and
Efficacy of a Ginkgo BilobaContaining Dietary Supplement on
Cognitive Function, Quality of Life, and Platelet Function in
Healthy, Cognitively Intact OlderAdults22/26Kim, SH (2005)Effects
of Ginkgo Biloba on Haemostatic Factors and Inflammation in Chronic
Peritoneal Dialysis Patients20/26
Mehlsen, J (2002)Effects of a Ginkgo Biloba Extract on Forearm
Haemodynamics in Healthy Volunteers17/26
