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Chinese Journal of Integrative Medicine

, Volume 25, Issue 1, pp 9–15 | Cite as

Effectiveness of Integrative Medicine Therapy on Coronary Artery Disease Prognosis: A Real-World Study

  • Kang Zhao
  • Jin-fan Tian
  • Cong Zhao
  • Fei Yuan
  • Zhu-ye Gao
  • Li-zhi Li
  • Hong-xu Liu
  • Xian Wang
  • Chang-jiang GeEmail author
  • Shu-zheng LuEmail author
Original Article

Abstract

Objective

To evaluate the effectiveness of integrative medicine (IM) on patients with coronary artery disease (CAD) and investigate the prognostic factors of CAD in a real-world setting.

Methods

A total of 1,087 hospitalized patients with CAD from four hospitals in Beijing, China were consecutively selected between August 2011 and February 2012. The patients were assigned to two groups based on the treatment: Chinese medicine (CM) plus conventional treatment, i.e., IM therapy (IM group); or conventional treatment alone (CT group). The endpoint was major adverse cardiac events [MACE; including cardiac death, myocardial infarction (MI), and revascularization].

Results

A total of 1,040 patients finished the 2-year follow-up. Of them, 49.4% (514/1,040) received IM therapy. During the 2-year follow-up, the total incidence of MACE was 11.3%. Most of the events involved revascularization (9.3%). Cardiac death/MI occurred in 3.0% of cases. For revascularization, logistic stepwise regression analysis revealed that age ⩾ 65 years [odds ratio (OR), 2.224], MI (OR, 2.561), diabetes mellitus (OR, 1.650), multi-vessel lesions (OR, 2.554), baseline high sensitivity C-reactive protein level ⩾ 3 mg/L (OR, 1.678), and moderate or severe anxiety/depression (OR, 1.849) were negative predictors (P<0.05); while anti-platelet agents (OR, 0.422), β-blockers (OR, 0.626), statins (OR, 0.318), and IM therapy (OR, 0.583) were protective predictors (P<0.05). For cardiac death/MI, age ⩾ 65 years (OR, 6.389) and heart failure (OR, 7.969) were negative predictors (P<0.05), while statin use (OR, 0.323) was a protective predictor (P<0.05) and IM therapy showed a beneficial tendency (OR, 0.587), although the difference was not statistically significant (P=0.218).

Conclusion

In a real-world setting, for patients with CAD, IM therapy was associated with a decreased incidence of revascularization and showed a potential benefit in reducing the incidence of cardiac death or MI.

Keywords

coronary artery disease Chinese medicine integrative medicine effectiveness real-world study 

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References

  1. 1.
    Ge CJ, Yuan F, Feng LX, Lu SZ, Liu H, Song XT, et al. Clinical effect of Maixuekang Capsule on long-term prognosis in patients with acute coronary syndrome after percutaneous coronary intervention. Chin J Integr Med 2014;20:88–93.CrossRefGoogle Scholar
  2. 2.
    He QY, Wang J, Zhang YL, Tang YL, Chu FY, Xiong XJ, et al. Effect of Yiqi Yangyin Decoction on the quality of life of patients with unstable angina pectoris. Chin J Integr Med 2010;16:13–18.CrossRefGoogle Scholar
  3. 3.
    Shang Q, Wang H, Li S, Xu H. The effect of sodium tanshinone A sulfate and simvastatin on elevated serum levels of inflammatory markers in patients with coronary heart disease: a study protocol for a randomized controlled trial. Evid Based Complement Alternat Med 2013;2013:756519.Google Scholar
  4. 4.
    Shang H, Zhang J, Yao C, Liu B, Gao X, Ren M, et al. Qi-shen-yi-qi dripping pills for the secondary prevention of myocardial infarction: a randomised clinical trial. Evid Based Complement Alternat Med 2013;2013:738391.Google Scholar
  5. 5.
    Wang SL, Wang CL, Wang PL, Xu H, Liu HY, Du JP, et al. 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. Evid Based Complement Alternat Med 2013;2013:741518.Google Scholar
  6. 6.
    Chen KJ, Shi DZ, Xu H, Lu SZ, Li TC, Ke YN, et al. XS0601 reduces the incidence of restenosis: a prospective study of 335 patients undergoing percutaneous coronary intervention in China. Chin Med J 2006;119:6–13.Google Scholar
  7. 7.
    Lu XY, Shi DZ, Xu H. Clinical study on effect of Xiongshao Capsule on restenosis after percutaneous coronary intervention. Chin J Integr Tradit Chin West Med (Chin) 2006;26:13–17.Google Scholar
  8. 8.
    Shang Q, Xu H, Liu Z, Chen K, Liu J. Oral Panax notoginseng preparation for coronary heart disease: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med 2013;2013:940125.Google Scholar
  9. 9.
    Luo J, Xu H, Chen K. Systematic review of Compound Danshen Dropping Pill: a chinese patent medicine for acute myocardial infarction. Evid Based Complement Alternat Med 2013;2013:808076.Google Scholar
  10. 10.
    Zheng GH, Liu JP, Chu JF, Mei L, Chen HY. Xiongshao for restenosis after percutaneous coronary intervention in patients with coronary heart disease. Cochrane Database Syst Rev 2013;5:CD009581.Google Scholar
  11. 11.
    Gao ZY, Qiu Y, Jiao Y, Shang QH, Xu H, Shi DZ. Analysis on outcome of 3537 patients with coronary artery disease: integrative medicine for cardiovascular events. Evid Based Complement Alternat Med 2013;2013:162501.Google Scholar
  12. 12.
    Tian F, Xie YM. Real-world study: a potential new approach to effectiveness evaluation of traditional Chinese medicine interventions. J Chin Integr Med (Chin) 2010;8:301–306.CrossRefGoogle Scholar
  13. 13.
    Chinese Society of Cardiology, Editorial Board of Chinese Journal of Cardiology. Guideline for diagnosis and treatment of patients with chronic stable angina. Chin J Cardiol (Chin) 2007;35:195–206.Google Scholar
  14. 14.
    Chinese Society of Cardiology, Editorial Board of Chinese Journal of Cardiology. Guideline for diagnosis and treatment of patients with unstable angina and non-STsegment elevation myocardial infarction. Chin J Cardiol (Chin) 2007;35295–35304.Google Scholar
  15. 15.
    Antman EM, Hand M, Armstrong PW, Bates ER, Green LA, Halasyamani LK, et al. 2007 focused update of the ACC/ AHA 2004 guidelines for the management of patients with ST-elevation myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2008;51:210–247.CrossRefGoogle Scholar
  16. 16.
    Chinese Society of Cardiology, Editorial Board of Chinese Journal of Cardiology. Guideline for diagnosis and treatment of acute heart failure. Chin J Cardiol (Chin) 2010;38:195–208.Google Scholar
  17. 17.
    Hunt SA. ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure). J Am Coll Cardiol 2005;46:e1–e82.CrossRefGoogle Scholar
  18. 18.
    Mancia G, de Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, et al. Guidelines for the management of arterial hypertension: the task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2007;28:1462–1536.Google Scholar
  19. 19.
    Joint Committee for the Prevention and Treatment of Dyslipidemia in Chinese Adults. Chinese guidelines on prevention and treatment of dyslipidemia in adults. Chin J Cardiol (Chin) 2007;35:390–419.Google Scholar
  20. 20.
    Boden WE, O'Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503–1516.CrossRefGoogle Scholar
  21. 21.
    Stone GW, Maehara A, Lansky AJ, de Bruyne B, Cristea E, Mintz GS, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med 2011;364:226–235.CrossRefGoogle Scholar
  22. 22.
    Majed B, Arveiler D, Bingham A, Ferrieres J, Ruidavets JB, Montaye M, et al. Depressive symptoms, a time-dependent risk factor for coronary heart disease and stroke in middleaged men: the PRIME Study. Stroke 2012;43:1761–1767.CrossRefGoogle Scholar
  23. 23.
    Park JH, Tahk SJ, Bae SH. Depression and anxiety as predictors of recurrent cardiac events 12 months after percutaneous coronary interventions. J Cardiovasc Nurs 2014;30:351–359.CrossRefGoogle Scholar
  24. 24.
    Cheng JM, Oemrawsingh RM, Garcia-Garcia HM, Akkerhuis KM, Kardys I, de Boer SP, et al. Relation of C-reactive protein to coronary plaque characteristics on grayscale, radiofrequency intravascular ultrasound, and cardiovascular outcome in patients with acute coronary syndrome or stable angina pectoris (from the ATHEROREMO-IVUS study). Am J Cardiol 2014;114:1497–1503.CrossRefGoogle Scholar

Copyright information

© Chinese Association of the Integration of Traditional and Western Medicine 2016

Authors and Affiliations

  • Kang Zhao
    • 1
  • Jin-fan Tian
    • 1
  • Cong Zhao
    • 1
  • Fei Yuan
    • 1
  • Zhu-ye Gao
    • 2
  • Li-zhi Li
    • 2
  • Hong-xu Liu
    • 3
  • Xian Wang
    • 4
  • Chang-jiang Ge
    • 1
    Email author
  • Shu-zheng Lu
    • 1
    Email author
  1. 1.Department of CardiologyBeijing Anzhen Hospital Affiliated to Capital Medical University—Beijing Institute of Heart, Lung and Blood Vessel DiseasesBeijingChina
  2. 2.Center for Cardiovascular Diseases, Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijingChina
  3. 3.Department of CardiologyBeijing Chinese Medicine Hospital Affiliated to Capital Medical UniversityBeijingChina
  4. 4.Department of CardiologyDongzhimen Hospital Affiliated to Beijing University of Traditional Chinese MedicineBeijingChina

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