The effect of Ginkgo biloba extract on platelet aggregation: a real-world clinical trial

Abstract Background and purpose There were reports that Ginkgo biloba extract (GBE) combined with aspirin induced bleeding events and the mechanism was not clear. Herein, the effects of GBE on platelet aggregation were discussed. Methods A total of 87 patients entered into this real-world study consecutively and finished final analysis, including 37 cases with internal jugular venous stenosis (IJVS) and 50 cases with acute ischemic stroke (AIS). Patients with AIS were divided into synergism group who underwent GBE combined with aspirin (66%, n = 33) and the aspirin group who underwent aspirin only (34%, n = 17). Patients with IJVS underwent GBE intravenous infusion only (n = 37). Data of plasma platelet and coagulation at baseline prior to and day 1 and 5 post-treatment were analyzed. And the antiplatelet activities were determined at baseline and day 5 post-treatment, respectively. Results GBE inhibits AA-induced rather than ADP-induced platelet aggregation, a directional trend in reduced rates of platelet aggregation was stimulated by AA on day 1 (P < 0.001) and day 5 (P = 0.040) and prolongs TT and APTT at the same time. Conclusions GBE could synergize with aspirin on inhibiting platelet aggregation in the suppression in AA pass way. Long-term combination of GBE and aspirin may increase the incidence of bleeding.