A randomized controlled trial of acupuncture in stable ischemic heart disease patients

Abstract

Background Heart rate variability (HRV) is reduced in stable ischemic heart disease (SIHD) patients and is associated with sudden cardiac death (SCD). We evaluated the impact of traditional acupuncture (TA) on cardiac autonomic function measured by HRV in SIHD patients. Methods We conducted a randomized controlled study of TA, sham acupuncture (SA), and waiting control (WC) in 151 SIHD subjects. TA group received needle insertion at acupuncture sites, SA group received a sham at non-acupuncture sites, while WC received nothing. TA and SA received 3 treatments/week for 12 wks. 24-hour, mental arithmetic stress, and cold pressor (COP) HRV was collected at entry and exit, along with BP, lipids, insulin resistance, hs-CRP, salivary cortisol, peripheral endothelial function by tonometry(PAT), and psychosocial variables. Results Mean age was 63±10; 50% had prior myocardial infarction. Comparison of WC and SA groups demonstrated differences consistent with the unblinded WC status; therefore by design, the control groups were not merged. Exit mental stress HRV was higher in TA vs. SA for markers of parasympathetic tone (p≤0.025), including a 17% higher vagal activity (p=0.008). There were no differences in exit 24-hour or COP HRV, BP, lipids, insulin resistance, hs-CRP, salivary cortisol, PAT, or psychosocial variables. Conclusions TA results in intermediate effects on autonomic function in SIHD patients. TA effect on HRV may be clinically relevant and should be explored further. These data document feasibility and provide sample size estimation for a clinical trial of TA in SIHD patients for prevention of SCD.

WITHDRAWN: Traditional acupuncture and myocardial ischemia

“…We read the recent article titled "A randomized controlled trial of acupuncture in stable ischemic heart disease patients" written by Puja K. Mehta et al with interest [1]. I am focusing on the traditional medicine in the diagnosis and treatment in cardiovascular disease, especially coronary heart disease.…”

“…Unfortunately, there were no group differences for such measures. In Puja K. Mehta's article, they thought that TA technique could significantly reduce angina pectoris in stable ischemic heart disease (SIHD) [1,2]. However, to the best of our knowledge, such secondary outcome measures cannot reflect the degree of myocardial ischemia, which is the physiopathologic mechanism of angina pectoris.…”

Traditional Chinese medicines in the management of cardiovascular diseases: a comprehensive systematic review

“…One trial compared genuine and sham acupuncture and found no difference in improvement of angina frequency or severity of attacks between the two groups, although there was a median reduction of 50% in anginal attack rate in both groups, implying a potentially beneficial effect from both genuine and sham acupuncture treatments . A similar study conducted in patients with stable ischaemic heart disease found a significant increase in heart rate variability, which has positive prognostic value, in patients receiving genuine acupuncture compared with sham treatment . T'ai chi has also been evaluated as a potential therapy and, whilst it does not modify measures such as heart rate variability, it has been demonstrated to improve baroreflex sensitivity .…”

Traditional acupuncture and myocardial ischemia

“…Unfortunately, there were no group differences for such measures. In Puja K. Mehta's article, they thought that TA technique could significantly reduce angina pectoris in stable ischemic heart disease (SIHD) [1,2].…”