CLZ and PTX demonstrated distinct effects on cognitive and inflammatory outcomes in patients with atherosclerotic cardiovascular disease (ASCVD). Findings presented at the American Heart Association (AHA) 2025 Sessions summarized a systematic review evaluating evidence from randomized controlled trials and observational studies conducted across four countries.

The systematic review included 19,966 individuals with ASCVD from six studies conducted in Brazil, Japan, Taiwan, and the United States. The analysis assessed the effects of CLZ and PTX on inflammatory markers, vascular stress, and cognitive outcomes using available clinical and biomarker data.

PTX significantly reduced CRP levels (P = 0.04) and TNF-α levels (P < 0.01). It also attenuated the decline in interleukin-10 (IL-10) levels compared with placebo (P < 0.01). Additional reported effects included improved blood flow through enhanced fibrinolysis, increased erythrocyte flexibility, and reduced neutrophil activation.

CLZ was associated with a lower risk of dementia (hazard ratio [HR] 0.75; 95% confidence interval [CI] 0.61–0.92). It was also associated with reduced risk of ischemic stroke (odds ratio [OR] 0.68; 95% CI 0.57–0.81; P < 0.0001) and hemorrhagic stroke (OR 0.43; 95% CI 0.29–0.64; P = 0.0001). However, randomized controlled trials showed no significant improvement in Mini-Mental State Examination (MMSE) scores over 96 weeks, and post-stroke cognitive outcomes did not improve consistently.

Overall, current evidence links CLZ to reduced dementia and stroke risk, while PTX demonstrates consistent anti-inflammatory effects. The findings describe distinct therapeutic profiles rather than definitive cognitive superiority.