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Effects of Qishen Yiqi Dripping Pills (芪参益气滴丸) in Reducing Myocardial Injury and Preserving Microvascular Function in Patients Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study

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Abstract

Objective

To evaluate the effect of treatment with Qishen Yiqi Dripping Pills (芪参益气滴丸, QSYQ) on myocardial injury and myocardial microvascular function in patients undergoing elective percutaneous coronary intervention (PCI).

Methods

Eighty patients undergoing elective PCI were randomly assigned to QSYQ and control groups. The QSYQ group received QSYQ at a dosage of 0.5 g 3 times daily (3–7 days before PCI and then daily for 1 month) and regular medication, which comprised of aspirin, clopidogrel, statin, β-blocker, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker in the absence of contradiction. The control group received only the regular medication. The index of microcirculatory resistance (IMR) was measured at maximal hyperemia after PCI. The fractional flow reserve was measured before and after the procedure. Troponin I levels were obtained at baseline and 20–24 h after the procedure.

Results

Pre-PCI troponin I levels between the two groups were similar (0.028±0.05 vs. 0.022±0.04 ng/mL, P=0.55). However, post- PCI troponin I levels in the QSYQ group were significantly lower than that in the control group (0.11±0.02 vs. 0.16±0.09 ng/mL, P<0.01). IMR values were significantly lower in the QSYQ group as compared to the control group (16.5±6.1 vs. 31.2±16.0, P<0.01). Multivariate analysis identified QSYQ treatment as the only independent protective factor against IMR >32 (odds ratio=0.29, 95% confidence interval: 0.11–0.74, P=0.01).

Conclusions

The present study demonstrated the benefit of QSYQ in reducing myocardial injury and preserving microvascular function during elective PCI.

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References

  1. Selvanayagam JB, Porto I, Channon K, Petersen SE, Francis JM, Neubauer S, et al. Troponin elevation after percutaneous coronary intervention directly represents the extent of irreversible myocardial injury: insights from cardiovascular magnetic resonance imaging. Circulation 2005;111:1027–1032.

    Article  CAS  PubMed  Google Scholar 

  2. Califf RM, Abdelmeguid AE, Kuntz RE, Popma JJ, Davidson CJ, Cohen EA, et al. Myonecrosis after revascularization procedures. J Am Coll Cardiol 1998;31:241–251.

    Article  CAS  PubMed  Google Scholar 

  3. Abdelmeguid AE, Topol EJ, Whitlow PL, Sapp SK, Ellis SG. Significance of mild transient release of creatine kinase-MB fraction after percutaneous coronary interventions. Circulation 1996;94:1528–1536.

    Article  CAS  PubMed  Google Scholar 

  4. Stone GW, Mehran R, Dangas G, Lansky AJ, Kornowski R, Leon MB. Differential impact on survival of electrocardiographic Q-wave versus enzymatic myocardial infarction after percutaneous intervention: a device-specific analysis of 7147 patients. Circulation 2001;104:642–647.

    Article  CAS  PubMed  Google Scholar 

  5. Saucedo JF, Mehran R, Dangas G, Hong MK, Lansky A, Kent KM, et al. Long-term clinical events following creatine kinase—myocardial band isoenzyme elevation after successful coronary stenting. J Am Coll Cardiol 2000;35:1134–1141.

    Article  CAS  PubMed  Google Scholar 

  6. Selvanayagam JB, Porto I, Channon K, Petersen SE, Francis JM, Neubauer S, et al. Troponin elevation after percutaneous coronary intervention directly represents the extent of irreversible myocardial injury: insights from cardiovascular magnetic resonance imaging. Circulation 2005;111:1027–1032.

    Article  CAS  PubMed  Google Scholar 

  7. Ricciardi MJ, Wu E, Davidson CJ, Choi KM, Klocke FJ, Bonow RO, et al. Visualization of discrete microinfarction after percutaneous coronary intervention associated with mild creatinekinase-MB elevation. Circulation 2001;103:2780–2783.

    Article  CAS  PubMed  Google Scholar 

  8. Aarnoudse W, Fearon WF, Manoharan G, Geven M, van de Vosse F, Rutten M, et al. Epicardial stenosis severity does not affect minimal microcirculatory resistance. Circulation 2004;110:2137–2142.

    Article  PubMed  Google Scholar 

  9. Ng MK, Yeung AC, Fearon WF. Invasive assessment of the coronary microcirculation: superior reproducibility and less hemodynamic dependence of index of microcirculatory resistance compared with coronary flow reserve. Circulation 2006;113:2054–2061.

    Article  PubMed  Google Scholar 

  10. Fearon WF, Balsam LB, Farouque HM, Caffarelli AD, Robbins RC, Fitzgerald PJ, et al. Novel index for invasively assessing the coronary microcirculation. Circulation 2003;107:3129–3132.

    Article  PubMed  Google Scholar 

  11. Du WX, Zhu MD, Feng LM, Song QG, Wei Y, Ma P, et al. Intervention effect of Qishen Yiqi Gutta Pills on early ventricular remodeling after acute myocardial infarction. Chin J Evid Based Cardiovasc Med (Chin) 2008;1:41–43.

    Google Scholar 

  12. Zhu MD, Du WX, Liu CY, Zhang JP, Feng LM, Wei Y, et al. Dynamic observation of Qishen Yiqi Gutta Pills on the myocardial inflammatory factors expression in acute myocardial infarction rats. Lishizhen Med Mater Med Res (Chin) 2013;24:22–25.

    Google Scholar 

  13. Fihn SD, Gardin JM, Abrams J, Berra K, Blankenship JC, Dallas AP, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol 2012;60:e44–e164.

    Article  PubMed  Google Scholar 

  14. Zheng XY, ed. Guiding principle of clinical research on new drugs of traditional Chinese medicine. Beijing: China Medic-Pharmaceutical Sciences and Technology Publishing House; 2002.

    Google Scholar 

  15. Fujii K, Kawasaki D, Oka K, Akahori H, Iwasaku T, Fukunaga M, et al. The impact of pravastatin pre-treatment on periprocedural microcirculatory damage in patients undergoing percutaneous coronary intervention. JACC Cardiovasc Interv 2011;4:513–520.

    Article  PubMed  Google Scholar 

  16. Pijls NH, van Son JA, Kirkeeide RL, De Bruyne B, Gould KL. Experimental basis of determining maximum coronary, myocardial, and collateral blood flow by pressure measurements for assessing functional stenosis severity before and after percutaneous transluminal coronary angioplasty. Circulation 1993;87:1354–1367.

    Article  CAS  PubMed  Google Scholar 

  17. Barbato E, Aarnoudse W, Aengevaeren WR, Werner G, Klauss V, Bojara W, et al. Validation of coronary flow reserve measurements by thermodilution in clinical practice. Eur Heart J 2004;25:219–223.

    Article  PubMed  Google Scholar 

  18. Fearon WF, Shah M, Ng M, Brinton T, Wilson A, Tremmel JA, et al. Predictive value of the index of microcirculatory resistance in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol 2008;51:560–565.

    Article  PubMed  Google Scholar 

  19. Cuisset T, Hamilos M, Melikian N, Wyffels E, Sarma J, Sarno G, et al. Direct stenting for stable angina pectoris is associated with reduced periprocedural microcirculatory injury compared with stenting after pre-dilation. J Am Coll Cardiol 2008;51:1060–1065.

    Article  PubMed  Google Scholar 

  20. Prati F, Pawlowski T, Gil R, Labellarte A, Gziut A, Caradonna E, et al. Stenting of culprit lesions in unstable angina leads to a marked reduction in plaque burden: a major role of plaque embolization? A serial intravascular ultrasound study. Circulation 2003;107:2320–2325.

    PubMed  Google Scholar 

  21. Pasceri V, Patti G, Nusca A, Pristipino C, Richichi G, Di Sciascio G, et al. Randomized trial of atorvastatin for reduction of myocardial damage during coronary intervention: results from the ARMYDA (Atorvastatin for Reduction of MYocardial Damage during Angioplasty) study. Circulation 2004;110:674–678.

    Article  CAS  PubMed  Google Scholar 

  22. Briguori C, Colombo A, Airoldi F, Violante A, Focaccio A, Balestrieri P, et al. Statin administration before percutaneous coronary intervention: impact on periprocedural myocardial infarction. Eur Heart J 2004;25:1822–1828.

    Article  CAS  PubMed  Google Scholar 

  23. Lin SQ, Wei XH, Huang P, Liu YY, Zhao N, Li Q, et al. Qishen Yiqi Pills prevents cardiac ischemia-reperfusion injury via energy modulation. Int J Cardiol 2013;168:967–974.

    Article  PubMed  Google Scholar 

  24. Hong C, Wang Y, Lou J, Liu Q, Qu H, Cheng Y. Analysis of myocardial proteomic alteration after Qishenyiqi Formula treatment in acute infarcted rat hearts. J Chin Mater Med (Chin) 2009;34:1018–1021.

    Google Scholar 

  25. Yan FF, Liu Y, Liu YF, Zhao YX. Effects of Qishen Yiqi Droplet on high sensitivity C reactive protein in experimental atherosclerosis rabbits. Shanghai J Tradit Chin Med (Chin) 2007;41:59–60.

    Google Scholar 

  26. Yan FF, Liu Y, Liu YF, Zhao YX. Effect of Qishen Yiqi Dripping Pills on histology of experimental atherosclerotic plaque. J Nanjing Univ Tradit Chin Med (Chin) 2007;23:295–297.

    Google Scholar 

  27. Yang L, Mao BY. Protection of Qisheng Yiqi Pills on rats with myocardial infarction. Chin J Exp Tradit Med Form (Chin) 2012;18:167–172.

    Google Scholar 

  28. Zhang L, Wang Y, Yu LY, Liu L, Qu H, Wang Y, et al. Qishen Yiqi accelerates angiogenesis after myocardial infarction in rats. Int J Cardiol 2010;143:105–109.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China

    Gui-xin He, Jun Xie & Biao Xu

  2. Department of Cardiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, China

    Gui-xin He, Hao Jiang & Wei Tan

Authors
  1. Gui-xin He
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  2. Jun Xie
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  3. Hao Jiang
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  5. Biao Xu
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Correspondence to Biao Xu.

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He, Gx., Xie, J., Jiang, H. et al. Effects of Qishen Yiqi Dripping Pills (芪参益气滴丸) in Reducing Myocardial Injury and Preserving Microvascular Function in Patients Undergoing Elective Percutaneous Coronary Intervention: A Pilot Randomized Study. Chin. J. Integr. Med. 24, 193–199 (2018). https://doi.org/10.1007/s11655-017-2955-1

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  • DOI: https://doi.org/10.1007/s11655-017-2955-1

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