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Efficacy of N-Butylphthalide on carotid atherosclerosis in patients with ischemic stroke: A pioneering 12-month study

cardiology
clinical-trials
drugs-and-devices
geriatrics
neurology

Abstract

Background : Ischemic stroke is a leading cause of mortality and disability worldwide, and carotid atherosclerosis is a significant contributing factor. N-butylphthalide (NBP), a compound derived from celery seeds, has shown promise in improving various atherosclerosis parameters. This study aimed to evaluate the efficacy of NBP in reducing vascular burden in patients with ischemic stroke over a 12-month period.
Methods : This community-based prospective study was conducted in Jizhou District, Tianjin, China, with patients newly diagnosed ischemic stroke. Participants were divided into a NBP treatment group and a control group. Baseline characteristics, carotid ultrasound data, and biochemical marker levels were recorded. Primary outcomes were changes in carotid intima-media thickness (CIMT), CIMT thickening rates, carotid plaques, and Crouse scores at 12-month follow-up.
Results : This study included 859 patients with ischemic stroke: 442 in the NBP group and 417 in the control group. After 12 months of treatment, the NBP group showed a significant reduction in CIMT (0.74 mm vs. 0.92 mm, P < 0.001), lower CIMT thickening rates (5.7% vs. 31.7%, P < 0.001), fewer carotid plaques (66.1% vs. 77.5%, P < 0.001), and lower Crouse score (2.81 vs. 3.61, P = 0.004) compared to the control group. The subgroup analysis and multivariate regression analyses confirmed that NBP was a protective factor for CIMT and Crouse scores independent of lipid-lowering medication use.
Conclusion : These results demonstrate that NBP effectively reduces carotid atherosclerotic parameters in patients with ischemic stroke, suggesting its potential as an adjunctive therapy for stroke prevention and management.
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