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
- 66 Downloads
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).
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.
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).
The present study demonstrated the benefit of QSYQ in reducing myocardial injury and preserving microvascular function during elective PCI.
Keywordsmyocardial injury microvascular impairment percutaneous coronary intervention Chinese medicine herbs
Unable to display preview. Download preview PDF.
- 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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
- 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
- 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.CrossRefPubMedGoogle 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.CrossRefPubMedGoogle 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