Abstract
Objective
To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome (ACS) after successful percutaneous coronary intervention (PCI).
Methods
One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine (WM) treatment group (WMG) and a combined treatment group (CMG) treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The followup was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association (NYHA) functional class, Chinese medicine (CM) symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events (MACE) were observed, serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and hyper-sensitivity C-reactive protein (Hs-CRP) were measured, an echocardiogram was conducted to examine left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), inter-ventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), and ventricular wall motion index (VWMI).
Results
Compared with the baseline, LVEF significantly increased (P<0.01), and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased (P<0.01) in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI (P>0.05). VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG (P<0.05 or P<0.01) at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG (6% vs 22%, P<0.05).
Conclusion
Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.
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References
Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction—executive summary. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction). J Am Coll Cardiol 2004;44:671–719.
Ferrari R, Perindopril and Remodeling in Elderly with Acute Myocardial Infarction Investigators. Effects of angiotensin-converting enzyme inhibition with perindopril on left ventricular remodeling and clinical outcome: results of the randomized Perindopril and Remodeling in Elderly with Acute Myocardial Infarction (PREAMI) Study. Arch Intern Med 2006;166:659–666.
Su CL, Shen SG. Modern cardiology of Chinese medicine. Beijing: Beijing Science and Technology Press; 1997:61–65.
Chinese Society of Cardiology, Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology. Diagnosis and treatment recommendations of unstable angina. Chin J Cardiol (Chin) 2000;28:409–412.
Chinese Society of Cardiology, Chinese Medical Association, Editorial Board of Chinese Journal of Cardiology, Editorial Board of Chinese Journal of Circulation. Diagnosis and treatment recommendations of acute myocardial infarction. Chin J Cardiol (Chin) 2001;29:705–720.
Committee of Cardiovascular Disease, Chinese Association of Integrated Traditional Chinese and Western Medicine. Standard of syndrome differentiation of coronary heart disease in Chinese medicine. Chin J Integr Tradit West Med (Chin) 1991;11:257.
Wang J, Chen KJ, Weng WL, Qian ZH, Wang Y, Liu JG, et al. Research on the diagnostic criteria of blood-stasis symptom-complex. Chin J Integr Tradit West Med (Chin) 1988;10:580–585.
Chen ZJ, Gao RL, eds. Studies on clinical coronary heart disease. Beijing: People’s Medical Publishing House;2002:381–405.
Wang XF, ed. Ultrasound echocardiography. Beijing: People’s Medical Publishing House; 2002:456–458.
Eigenbaum H, ed. Echocardiography. 4th ed. Philadelphia: Lea and Febiger; 1986:462–513.
Møller JE, Hillis GS, Oh JK, Reeder GS, Gersh BJ, Pellikka PA. Wall motion score index and ejection fraction for risk stratification after acute myocardial infarction. Am Heart J 2006;151:419–425.
Shereif H R, Robert AK. No-reflow phenomenon. Circulation 2002;105:656–662.
Gong X, Yang J, Fang YM. No-reflow phenomenon following reperfusion in acute myocardial infarction. Medical Recapit (Chin) 2006;12:480–482.
Dzavík V, Buller CE, Lamas GA, Rankin JM, Mancini GB, Cantor WJ, et al. Randomized trial of percutaneous coronary intervention for subacute infarct-related coronary artery occlusion to achieve long-term patency and improve ventricular function: the Total Occlusion Study of Canada (TOSCA)-2 trial. Circulation 2006;114:2449–2457.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, et al. Recommendations for chamber quantification. Eur J Echocardiogr 2006;7:79–108.
Ranjith N, Pegoraro RJ, Naidoo DP, Kaloo AS, Esterhuizen TM. The role of echocardiography and its comparison with NT-proBNP measurements in patients with acute myocardial infarction. Med Sci Monit 2007;13:CR574–CR578.
Biagini E, Galema TW, Schinkel AF, Vletter WB, Roelandt JR, Ten Cate FJ. Myocardial wall thickness predicts recovery of contractile function after primary coronary intervention for acute myocardial infarction. J Am Coll Cardiol 2004;43:1489–1493.
Olsen MH, Wachtell K, Nielsen OW, Hall C, Wergeland R, Ibsen H, et al. N-terminal brain natriuretic peptide predicted cardiovascular events stronger than high-sensitivityC-reactive protein in hypertension: a LIFE substudy. J Hypertens 2006;24:1531–1539.
Jernberg T, Stridsberg M, Venge P, Lindahl B. N-terminal probrain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation. J Am Coll Cardiol 2002;40:437–445.
FRISC-II Study Group. Invasive compared with noninvasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. FRagmin and Fast Revascularisation during Instability in Coronary Artery Disease Investigators. Lancet 1999;354:708–715
Abbate A, Biondi-Zoccai GG, Brugaletta S, Liuzzo G, Biasucci LM. C-reactive protein and other inflammatory biomarkers as predictors of outcome following acute coronary syndromes. Semin Vasc Med 2003;3:375–384.
He LP, Tang XY, Ling WH, Chen WQ, Chen YM. Early C-reactive protein in the prediction of long-term outcomes after acute coronary syndromes: a meta-analysis of longitudinal studies. Heart 2010;96:339–346.
Li YQ, Jin M, Qiu SL, Wang PL, Zhu TG, Wang CL, et al. Effect of Chinese drugs for supplementing qi, nourishing yin and activating blood circulation on myocardial perfusion in patients with acute myocardial infarction after revascularization. Chin J Integr Med 2009;15:19–25.
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Supported by the Key Projects in the National Science and Technology Pillar Program during the Eleventh Five-year Plan Period (No. 2006BA104A01)
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Liu, Hy., Wang, W., Shi, Dz. et al. Protective effect of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome after percutaneous coronary intervention. Chin. J. Integr. Med. 18, 423–430 (2012). https://doi.org/10.1007/s11655-012-0966-5
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DOI: https://doi.org/10.1007/s11655-012-0966-5