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Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter, Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study

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Abstract

Objective

To explore the effect of Shenmai Injection (SMI) on the long-term prognosis of patients with chronic heart failure (CHF).

Methods

The Hospital Information System was used to extract data of CHF patients, and the retrospective cohort study was conducted for analysis. In non-exposed group, standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group, SMI were applied for more than 7 days. Evaluation indicators are followed with New York Heart Association functional classification (NYHA classification), left ventricular ejection fraction (LVEF), N-terminal brain natriuretic peptide precursor (NT-ProBNP), cardiogenic death and heart failure (HF) readmission. Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events.

Results

A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up successfully. After treatment, the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30% and 43.45%, respectively; the improvement values of LVEF were 8.89% and 7.91%, respectively; the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL, respectively. After exposure on SMI, the rates of cardiogenic death and HF readmission reduced from 15.43% to 10.18% and 38.93% to 32.37%. According to Kaplan-Meier analysis, the log-rank P value of SMI and cardiogenic death was 0.014, while the counterpart of SMI and HF readmission was 0.025. Cox regression analysis indicated that for cardiogenic death, age, cardiomyopathy, diabetes, and NYHA classification were risk factors while β-blockers, aldosterone receptor antagonists, Chinese patent medicine/decoction and SMI were protective factors. Likewise, for HF readmission, age, cardiomyopathy, and NYHA classification were risk factors while SMI was a protective factor.

Conclusion

Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients, and thereby improve the long-term prognosis.

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Authors and Affiliations

  1. The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, 250014, China

    Hui Guan, Cong Sun, Li-li Ren, Xiao-ming Hou & Zhang Liu

  2. Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, China

    Guo-hua Dai, Wu-lin Gao & Tong Zhang

Authors
  1. Hui Guan
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  2. Guo-hua Dai
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  3. Wu-lin Gao
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  4. Tong Zhang
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  5. Cong Sun
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  6. Li-li Ren
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  7. Xiao-ming Hou
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  8. Zhang Liu
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Contributions

This project was initiated and developed by Dai GH and Guan H. Dai GH, Guan H were involved in the design of the study. Guan H, Gao WL were involved in drafting and writing the manuscript. Sun C, Liu Z were involved in the extraction of data. Ren LL, Hou XM were involved in the follow-up of the patients. Guan H was involved in the statistical analysis of data. Zhang T was involved in data checking. All authors read and approved the final manuscripts.

Corresponding author

Correspondence to Guo-hua Dai.

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The authors report no conflict of interest.

Additional information

Supported by National Key R&D Program of China (No. 2019YFC1710400 and No. 2019YFC1710401) and National Natural Science Foundation of China (No. 81774047)

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Guan, H., Dai, Gh., Gao, Wl. et al. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter, Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study. Chin. J. Integr. Med. 28, 312–318 (2022). https://doi.org/10.1007/s11655-021-2875-y

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  • DOI: https://doi.org/10.1007/s11655-021-2875-y

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