A Prospective Cohort Study on the Risk of Major Adverse Cardiovascular Events in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention with Blood-invigorating and Stasis-dissolving Medicinals
10.13288/j.11-2166/r.2024.18.009
- VernacularTitle:活血化瘀中药干预冠心病患者经皮冠状动脉介入术后一年主要心血管事件风险的前瞻性队列研究
- Author:
Lintong YU
1
;
Shiyi TAO
1
;
Xiaojuan MA
2
;
Jie GAO
2
;
Hua QYU
2
;
Yu YANG
1
;
Bingchang CHEN
2
;
Dazhuo SHI
2
Author Information
1. Graduate School of Beijing University of Chinese Medicine，Beijing，100029
2. Xiyuan Hospital，China Academy of Chinese Medical Sciences
- Publication Type:Journal Article
- Keywords:
coronary heart disease;
blood-invigorating and stasis-dissolving medicinals;
post-percutaneous coronary intervention;
major cardiovascular events
- From:
Journal of Traditional Chinese Medicine
2024;65(18):1895-1902
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo explore the impact of blood-invigorating and stasis-dissolving medicinals combined with conventional western medicine on the major adverse cardiovascular events （MACE） in patients with coronary heart disease （CHD） after percutaneous coronary intervention （PCI）. MethodsA prospective cohort study was conducted to collect data on consecutive cases of CHD after PCI. According to whether blood-invigorating and stasis-dissolving medicinals were used， the cases were divided into a Chinese herbal medicinals （CHM） group and control group. The primary outcome was the incidence of MACE one year after PCI， while the secondary outcomes included TCM syndrome score and echocardiography left ventricular ejection fraction （LVEF）. Logistic regression analysis was performed to explore the influencing factors of MACE. ResultsA total of 844 patients who met the criteria were included， with 617 in the CHM group and 227 in the control group. The main blood-invigorating and stasis-dissolving medicinals being used were Danshen （Radix et Rhizoma Salviae Miltiorrhizae， 46.35%）， Chuanxiong （Rhizoma Chuanxiong， 45.87%）， and Chishao （Radix Paeoniae Rubra， 42.30%）. After a median follow-up of 12.73 months， the incidence of MACE in the CHM group （142/617， 23.01%） was significantly lower than that in the control group （68/227， 29.96%） with significant difference （OR=0.70， 95%CI 0.50 to 0.98， P = 0.04）. The LVEF of the CHM group ［（60.06±6.13）%］ was higher than that of the control group ［（58.27±7.36）%］ with significant difference （t = 0.356， P＜0.01）. The TCM syndrome score in the CHM group decreased to 12.66±4.47， while that in the control group increased to 13.81±3.88， with the results favoring the CHM group （t = 2.78， P＜0.01）. Univariate analysis showed correlations between the incidence of MACE after PCI and the use of blood-invigorating and stasis-dissolving medicinals， LVEF， usage of renin-angiotensin-aldosterone system （RAAS） inhibitors， TCM syndrome score， and usage of β blockers （P＜0.05）. Multivariate analysis showed that the use of blood-invigorating and stasis-dissolving medicinals was significantly associated with the reduction of MACE （P＜0.01）， while the baseline LVEF decline， TCM syndrome score increase， no use of RAAS inhibitors or β blockers were the risk factors of MACE after PCI （P＜0.05）. ConclusionThe use of blood-invigorating and stasis-dissolving medicinals based on the conventional western medicine can reduce the risk of MACE one year after PCI of CHD， improve the TCM syndromes and protect heart function.
