, Volume 18, Issue 11, pp 807-812
Date: 16 Aug 2012

Clinical efficacy of traditional chinese medicine on acute myocardial infarction—A prospective cohort study

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Abstract

Objective

To evaluate the clinical effects of Chinese medicine (CM) on acute myocardial infarction (AMI) with a prospective cohort study.

Methods

A total of 334 AMI patients from January 2007 to March 2009 were consecutively enrolled, and were assigned to a treatment group (169 cases) treated with combined therapy (CM for at least one month and Western medicine) and a control group (165 cases) with Western medicine alone. Clinical data including age, gender, smoking, medical history, infarction area, heart functional classification, CM syndrome scores, blood-stasis syndrome score, primary end-point (death, nonfatal myocardial infarction, and revascularization) and secondary end-point (ischemic stroke, rehospitalization due to angina, heart failure and shock), were collected. CM syndrome scores, blood-stasis syndrome score, primary end-point and secondary end-point were collected during the 6-month follow-up. Kaplan-Meier method was used for the survival analysis. The multifactor analysis was analyzed by Cox proportional hazards regression.

Results

At the end of 6-month the CM syndrome score and bloodstasis syndrome score in the treatment group were lower than those in the control group (P<0.01), especially the symptoms of chest pain, spontaneous perspiration and insomnia. Rehospitalization rate due to angina during the 6-month follow-up in the treatment group (2.96%) was lower than that in the control group (7.88%, P<0.05). Kaplan- Meier survival curve showed that event-free cumulated survival of rehospitalization due to angina during the 6-month follow-up in the treatment group was higher than that in the control group (Log rank 4.700, P=0.03). Cox regression analysis showed that heart dysfunction [hazard ratio (HR)=1.601, 95% CI=1.084–2.364, P=0.018] and diabetes mellitus (HR=1.755, 95% CI=1.031–2.989, P=0.038) were hazard factors to end-point, whereas CM (HR 0.405, 95% CI=0.231–0.712, P=0.002), percutaneous coronary intervention (PCI, HR=0.352, 95% CI=0.204–0.607, P<0.001) and angiotensin converting enzyme (ACE) inhibitors (HR=0.541, 95% CI=0.313–0.936, P=0.028) were protective factors.

Conclusions

CM therapy could decrease CM syndrome scores and blood-stasis syndrome score, reduce the rehospitalization rate during 6-month follow-up due to angina. Heart dysfunction and diabetes mellitus were hazard factors to end-point, whereas CM, PCI and ACE inhibitors were protective factors.

Supported by Grants from National Eleventh Five-Year Key Programs for Science and Technology Development of China (No. 2006BAI04A01-2) and the Second Group Dominant Disease of China Academy of Chinese Medical Sciences (No. CACMS07Y001)