Abstract:

Objective To observe the effects of ginkgolides drops on anginal attacks and peripheral blood levels of microRNA?29 a （miR?29a） and intercellular adhesion molecule?1 （ICAM?1） in patients with stable angina pectoris. Methods 78 patients with stable angina pectoris patients， who had visited the cardiology department of our hospital during the period of January 2022 to December 2023， were selected. The patients were divided in a Chinese medicine group or a conventional group by using the random number table method， 39 in each group. The conventional group received conventional Western medicine treatment， while the Chinese medicine received ginkgo ketone ester drip pills on the basis of conventional Western medicine therapies. Occurrence of angina attack， treadmill electrocardiogram test indexes， blood rheology， 6?minute walking distance， TCM symptom scores and changes in peripheral blood miR?29a and ICAM?1 were observed in the two groups. The rate of nitroglycerin discontinuation or reduction and the incidence of adverse reactions were counted. Results Before treatment， there was no statistically significant difference in occurrence of angina attacks between the two groups （P > 0.05）. After treatment， the number of attacks per week， weekly glyceryl trinitrate uses， and duration of each attack decreased in both groups， with a greater decline in the Chinese medicine group than in the conventional group （P < 0.05）. Before treatment， there was no statistically significant difference in the indicators of treadmill electrocardiogram test between the two groups （P > 0.05）. After treatment， induction positive time， exercise termination time， and maximum ST depression time increased in both groups， with longer induction positive time and maximum ST depression time in the Chinese medicine group than in the conventional group， while exercise termination time， as compared with the baseline， did not differ statistically （P > 0.05）. Maximum ST depression amplitude and ST recovery time decreased in both groups， with a greater decrease in the Chinese medicine group than in the conventional group （P < 0.05）. Before treatment， there were no statistically significant differences in miR?29a， ICAM?1， and rheology between the two groups （P > 0.05）. After treatment， ICAM?1 and whole blood high/low shear viscosity， FIB， platelet aggregation rate， and plasma viscosity decreased in both groups， with a bigger drop in the Chinese medicine group than in the conventional group （P < 0.05）. As compared with the baseline， miR?29a did not differ statistically between the two groups （P > 0.05）. Before treatment， there were no statistically significant differences in 6min walking distance and Chinese medicine symptom scores between the two groups. After treatment， 6 min walking distance increased in both groups， with a greater increase in the Chinese medicine group than in the conventional group （P < 0.05）； Chinese medicine symptom scores decreased in both groups， with a greater decrease in the Chinese medicine group than in the conventional group （P < 0.05）. The glyceryl trinitrate reduction rate was higher in the Chinese medicine group （79.49%， 31/39 cases） than in the conventional group （56.41%， 22/39 cases）， and the incidence of adverse reactions did not differ statistically between the Chinese medicine group and the conventional group （7.69% vs. 5.13%， 3/39 vs. 2/39 cases； P > 0.05）. Conclusions Ginkgolides drops for stable angina improve the degree of myocardial ischaemia and blood rheology， reduce angina attacks， lower ICAM?1 levels， and increase the rate of nitroglycerin discontinuation or reduction.

Key words: ginkgolides drops, stable angina, myocardial ischaemia, haemorheology, nitroglycerin withdrawal rate