Protective Effects of Salvianolate on Myocardial Injury or Myocardial Infarction after Elective Percutaneous Coronary Intervention in NSTE-ACS Patients: A Randomized Placebo-Controlled Trial.

OBJECTIVE: To evaluate the protective effects of salvianolate on percutaneous coronary intervention (PCI) related myocardial injury or myocardial infarction after elective PCI in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients. METHODS: A total of 149 patients with NSTE-ACS who underwent elective PCI were enrolled. The patients were randomly allocated in a 1:1 ratio to the salvianolate group (74 cases) or the control group (75 cases). After exclusion criteria of coronary angiography, 60 patients with PCI therapy remained in the salvianolate group and 68 in the control group. The incidence and the severity of PCI related myocardial injury or myocardial infarction, in addition to major adverse cardiac events (MACEs) during 1 year follow-up after PCI were studied between the two groups. Multivariate logistic regression analysis was used to determine the independent factors for PCI related myocardial injury or myocardial infarction after elective PCI. RESULTS: Compared with the control group, salvianolate treatment reduced the incidence of PCI related severe myocardial injury or myocardial infarction (11.7% vs. 26.5%, P=0.035). The rate of MACEs or all-cause death within 1 month or 1 year after the procedure was not significantly different between the two groups. CONCLUSIONS: Periprocedural treatment with salvianolate reduces the incidence of PCI related severe myocardial injury or myocardial infarction, although it does not influence clinical prognosis. [Chinese clinical trial registry: ChiCTR1800016992].

[Evaluation on clinical effect of long-term shexiang baoxin pill administration for treatment of coronary heart disease].

OBJECTIVE: To evaluate the effect of long-term Shexiang Baoxin Pill (SXBXP) administration on cardiovascular events in patients with stable angina pectoris (SAP). METHODS: A prospective randomized non-blind parallel controlled study was conducted in the early stage (the first 6 months) of the trial, then a cohort study was succeeded in the later stage. Two hundred patients with SAP, who visited the hospital between May 2005 and June 2006, were selected and randomly assigned to the trial group and the control group, 100 patients in each group. Both were treated with conventional therapy, including treatment for anti-platelet, blood lipid regulating, anti-ischemia, etc, and to patients in the trial group, SXBXP was administered additionally for 2 pills, three times a day by oral intake. The therapeutic course lasted for at least 6 months. All patients were followed up until January 2008, the clinical events and conditions of treatment were recorded. The composite terminal of various cardiovascular events was regarded as the primary endpoint. RESULTS: The median follow-up time of the study was 2.25 years (ranging from 0.5 to 2.75 years). In the trial group, the occurrence (cases) was 23 for all-clinical event, 20 for primary-clinical event and 9 for angina pectoris event, which were lesser than those in the control group, 33, 29 and 19 cases respectively, showing a significant difference between groups (P < 0.05). The dosage of nitrates used in the trial was decreased more than that before treatment. Besides, all the incidences (cases), in terms of all-cause death (2 vs 5), cardiovascular death (1 vs 2), congestive heart failure (3 vs 4), stroke (2 vs 4), and other clinical (5 vs 6) events, as well as in the need for percutaneous coronary intervention or coronary artery bypass graft (2 vs 4), showed somewhat lowering in the trial group as compared with the corresponding items in the control group, but statistical analysis showed an insignificant difference between them (P > 0.05). CONCLUSION: Long-term SXBXP administration could reduce the occurrence of angina pectoris events and some other clinical events, and cut down the dosage of nitrates used in patients with SAP.

Oral L-arginine supplementation in acute myocardial infarction therapy: a meta-analysis of randomized controlled trials.

OBJECTIVE: The objective was to analyze completed trials assessing the effect of oral L-arginine supplementation on clinical outcomes of patients with acute myocardial infarction (AMI). BACKGROUND: Prior trials suggest that oral L-arginine administration improves endothelial function in patients with stable coronary artery disease (CAD). However, it is still unclear whether oral supplementation of L-arginine has any effect on clinical outcomes in patients with unstable CAD, such as AMI. METHODS: We systematically searched PubMed, Cochrane Library, Embase, reviews, and reference lists of relevant articles. The search strategy paired the term "arginine" with the following: "coronary heart disease," "myocardial infarction," "cardiovascular disease," "ischemia," and "trial." We conducted a meta-analysis of randomized, placebo-controlled L-arginine supplementation trials that evaluated clinical outcomes in AMI patients. Two reviewers independently assessed the trials. Differences were resolved by consensus. RESULTS: Only 2 trials (927 participants) were included. None of the 2 studies showed a significant difference in event rate between the L-arginine and placebo groups. In an overall pooled estimate, there was a 7% reduction in mortality in the L-arginine treatment group (105/459, 22.9%) compared with the control group (111/455, 24.4%), which did not reach statistical significance (risk ratio [RR]: 0.93, 95% confidence interval [CI]: 0.74-1.17; P = 0.54). CONCLUSION: Oral L-arginine supplementation has no effect on the clinical outcomes of patients with AMI.

[Evaluation on tolerability and safety of long-term administration with shexiang baoxin pill in patients with coronary heart disease of stable angina pectoris].

OBJECTIVE: To evaluate the safety and tolerability of long-term (6 months) administration with Shexiang Baoxin Pill (SBP) in patients with coronary heart disease (CHD) of stable angina pectoris. METHODS: Adopting randomized non-blinded and parallel controlled trial, 200 patients with CHD were randomly and equally assigned to the SBP group and the control group. Both received basic therapy for CHD, including anti-platelet, lipid regulating and anti-ischemia with additional SBP 2 pills, taken orally three times per day in the SBP group. They were followed up for 6 months. The drug tolerability and adverse drug reactions occurred in the observation period were recorded, and the laboratory indexes involving blood routine, liver function, renal function, blood glucose and blood lipids were detected before and after treatment. RESULTS: The trial was completed in 92% of the patients, 5 patients withdrew in the SBP group and 11 patients in the control group; but none for the intolerable therapy. There were 1 case of adverse reaction related to SBP. No obvious change was found in blood glucose and blood lipids in the two groups before and after treatment. No serious adverse reaction and injury of liver and renal function or others happened. CONCLUSION: Long-term administration of SBP has favorable clinical tolerability and safety for CHD patients.

[Effect of Zhenju Jiangya Tablet on the endothelial function of hyperlipidemic rabbits].

OBJECTIVE: To study the effect of Zhenju Jiangya Tablet (ZJ) on the injured endothelial cells and endothelium-dependent relaxation function of hyperlipidemia rabbits. METHODS: Male New Zealand rabbits were randomized into four groups: control group, hyperlipidemia group, ZJ group and sivastatin group. The endothelium-dependent relaxation function was evaluated by APV using intravascular Doppler, and the morphology of endothelial cells was detected by light microscopy and electron microscopy, and nitric oxide synthase was evaluated. RESULTS: ZJ reduced the lesions of hyperlipidemia vessels, and the APV after Ach injection of each group was (1.14+/-0.26), (1.74+/-0.59), (1.22+/-0.37) and (1.17+/-0.41) respectively. The eNOS of each group was (4.21+/-0.37), (1.43+/-0.88), (3.95+/-0.67) and (4.08+/-0.46) nmol x min(-1) x g(-1) respectively. CONCLUSION: ZJ can improve the abnormality of endothelial cells and endothelium-dependent relaxation function of hyperlipidemia.