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Only subgroup analyses found significant benefits of citicoline in patients older than 70 years, in those with moderate rather than severe strokes, and in those not treated with recombinant tissue plasminogen activator (rtPA

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Plaque rupture exposes pro-thrombotic material to the bloodstream, triggering the formation of blood clots that can occlude arteries and lead to acute cardiovascular events such as myocardial infarction and stroke [74]

The C-terminal amidation is critical for full biological activity, as the free-acid form shows significantly reduced receptor binding