Combination of Chinese Herbal Medicines and Conventional Treatment versus Conventional Treatment Alone in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention (5C Trial): An Open-Label Randomized Controlled, Multicenter Study

Abstract

Aims. To evaluate the efficacy of Chinese herbal medicines (CHMs) plus conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). Methods and Results. Participants (n = 808) with ACS who underwent PCI from thirteen hospitals of mainland China were randomized into two groups: CHMs plus conventional treatment group (treatment group) or conventional treatment alone group (control group). All participants received conventional treatment, and participants in treatment group additionally received CHMs for six months. The primary endpoint was the composite of cardiac death, nonfatal recurrent MI, and ischemia-driven revascularization. Secondary endpoint was the composite of readmission for ACS, stroke, or congestive heart failure. The safety endpoint involved occurrence of major bleeding events. The incidence of primary endpoint was 2.7% in treatment group versus 6.2% in control group (HR, 0.43; 95% CI, 0.21 to 0.87; P = 0.015). The incidence of secondary endpoint was 3.5% in treatment group versus 8.7% in control group (HR, 0.39; 95% CI, 0.21 to 0.72; P = 0.002). No major bleeding events were observed in any participant. Conclusion. Treatment with CHMs plus conventional treatment further reduced the occurrence of cardiovascular events in patients with ACS after PCI without increasing risk of major bleeding.

Qing-Xin-Jie-Yu Granules in addition to conventional treatment for patients with stable coronary artery disease (QUEST Trial): study protocol for a randomized controlled trial

“…QXJYG consist of five herbal granules, including Astragalus membranaceus (Huangqi), Salvia miltiorrhiza Bunge (Danshen), Ligusticum chuanxiong Hort (Chuanxiong), Agastache rugosus (Huoxiang), and Coptis chinensis (Huanglian). The pharmacological studies suggested that the bioactive component or structural modification of extracts from Huangqi [ 9 ], Danshen [ 10 ], and Chuanxiong [ 11 ] had effects on cardiac protection, plaque stabilization, inhibition of platelet aggregation, etc., and these three Chinese herbs are also widely used in TCM for treating CAD [ 12 – 14 ]. Moreover, extracts from Danshen and Huanglian exert anti-inflammatory effects [ 15 , 16 ], and clinical studies showed that they decreased the level of high-sensitivity CRP (hs-CRP) in patients with cardiovascular disease [ 17 , 18 ].…”

Effect of Xinyue capsules on patients with coronary heart disease after percutaneous coronary intervention: study protocol for a randomized controlled trial

“…Previous studies have shown that PQS has various pharmacological actions, including anti-myocardial cell damage [ 6 ], protection of heart function, reduction of myocardial oxygen consumption [ 7 , 8 ], improvement of myocardial perfusion [ 9 ] and ventricular remodeling after acute myocardial infarction (MI) [ 10 ], antiapoptosis of ischemic myocardial cells [ 11 , 12 ], regulation of glucose and lipid metabolism [ 13 ], and improvement of insulin resistance [ 14 , 15 ]. A multicenter randomized clinical study [ 16 ] showed that the combination of Xinyue capsules with Chuanxiong capsules and conventional Western interventions could reduce the occurrence of cardiovascular events in patients with ACS after PCI without increasing the risk of major bleeding. The results of pharmaceutical chemistry and pharmacokinetics conducted jointly by Xiyuan Hospital and Medical University of Vienna showed that the fingerprint of Xinyue capsules from different batches or the same batch at different time points was consistent, and the measurements of heavy metal and pesticide residues were within European Union standards.…”

Interaction ofPanax quinquefoliusSaponin and Dual Antiplatelets on Vascular Endothelial Function in Rats with Acute Myocardial Infarction

“…In Asia, HM is used for prevention and treatment of coronary heart disease (CHD) in many countries for thousands of years. Many studies showed that the combination therapy of HM and conventional western medicine significantly improved life quality and prognosis of patients after PCI [ 4 , 5 ]. Clinical application of dual antiplatelet drugs such as aspirin and clopidogrel is important in the prevention and therapy of CHD, but prolonged treatment with dual or triple antiplatelet drugs revealed a diversity of platelet reactions, which limits the clinical application widely.…”