A cross-sectional study of factors related to traditional Chinese medicine use for hospitalized acute coronary syndrome patients in China's level 2 hospitals / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore the current status on traditional Chinese medicine (TCM) use for hospitalized acute coronary syndrome patients in China's level 2 hospitals, and to explore associated factors of TCM use for these patients.</p><p><b>METHODS</b>This survey was performed in 102 level 2 hospitals from 15 provinces or autonomous region in China. Patients admitted to these hospitals with acute coronary syndrome during September 2011 to May 2012 were eligible for this study. Information on TCM use was obtained from their medical records. Chi-square test and logistic regression analysis were used to explore the related factors of TCM use in these patients.</p><p><b>RESULTS</b>We recruited 5 432 acute coronary syndrome patients in this study, TCM was applied to 3 503 patients (64.5%). Multivariable logistic regression showed that pre-hospital TCM use was positively related with in-hospital TCM use (OR = 2.08, P < 0.01) , while pre-hospital use of 4 medicines recommended by the guidelines(including aspirin/clopidogrel, β acceptor blocker, stain and angiotensin converting enzyme inhibitor/angiotensin converting enzyme receptor blocker ), being a smoker and diagnosis of myocardial infarction rather than unstable angina at hospital discharge were negatively related with in-hospital TCM use (the ORs were 0.58, 0.78 and 0.71, respectively, all P < 0.01). The TCM use varied significantly between regions. Taking southwest region as a reference, the ORs varied between 2.98-13.37 (all P < 0.01) in eastern China, south China, central China, north China, northwest and northeast regions.</p><p><b>CONCLUSIONS</b>TCM is widely used in hospitalized acute coronary syndrome patients in China's resource-constrained level 2 hospitals. Pre-hospital TCM use is positively correlated with in-hospital TCM use for these patients.</p>

Efficacy and safety of nifedipine GITS in Asians with hypertension: results of a post-marketing surveillance study in China.

OBJECTIVE: This post-marketing surveillance study assessed the efficacy, safety and tolerability of treatment with nifedipine GITS (gastrointestinal therapeutic system) in hypertensive patients with different risk profiles under normal daily practice conditions in China. METHODS: A total of 7395 patients were included in 564 outpatient clinics. Patients received 30mg or 60mg of nifedipine GITS, which could be up- and down-titrated if necessary. Efficacy, safety and tolerability data were collected at up to three follow-up visits. Patient documentation was completed using standardised and barcoded case report forms. Descriptive and explorative analyses of the data were performed. RESULTS: At endpoint, 93% of patients were receiving 30mg of nifedipine GITS and 7% were taking 60mg of nifedipine GITS. The mean observation period was 9 +/- 7 weeks. At endpoint, the mean BP reduction was 27.7/14.8mm Hg; 43% of patients had a systolic BP <140mm Hg, and 58% had a diastolic BP <90mm Hg. BP control as recommended by international guidelines was achieved in 43.5% of all patients. A total of 3163 patients (42.8%) received additional antihypertensive medication, of which ACE inhibitors were most commonly used (40.7%), followed by beta-adrenoceptor antagonists (25.8%).Twenty-nine patients (0.4%) experienced a total of 39 adverse events. Subjective physicians' assessments of efficacy, tolerability and patient acceptance of nifedipine GITS treatment returned ratings of 'very good' and 'good' in 91-95% of each category. CONCLUSIONS: Nifedipine GITS proved to be effective and well tolerated for the treatment of hypertension in 7395 Chinese patients under normal daily practice conditions. The results confirm the findings and experience of previously performed clinical studies.

Effect of tongxinluo on endothelin-1 in the mini-swine model of acute myocardial infarction and reperfusion / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the change of endothelin-1 (ET-1) in the mini-swine model of acute myocardial infarction (AMI) and reperfusion and the effect of Tongxinluo (TXL) on it, and to explore the possible mechanism of no-reflow.</p><p><b>METHODS</b>Forty mini-swines were randomized into 5 groups: the model group, the small,middle and large dose of TXL groups and the sham-operated group, 8 in each group. The AMI reperfusion model was established by coronary ligation for 3 hrs followed with relaxation for 1 hr. Plasma ET-1 content before and after AMI, and after reperfusion was determined respectively by radioimmunoassay. The ET-1 mRNA expression in myocardial tissue of normal, ischemic and no-reflow area were respectively quantified by reverse transcription-polymerase chain reaction.</p><p><b>RESULTS</b>(1) Compared with before AMI, levels of plasma ET-1 at the time points of 5 min and 3 hrs after AMI, 5 min and 1 hrs after reperfusion in the model group were significantly raised, showing an increasing tendency (all P < 0.01). But the increment in the middle and large dose of TXL groups were all lower than that in the model group (P < 0.05). (2) In the model and the TXL groups, levels of ET-1 in myocardial tissue of ischemic and no-reflow area were significantly higher than those in the normal area, and the increment in no-reflow area was higher than that in ischemic area (all P < 0.01). Compared with the model group, significant lowering of ET-1 in ischemic area was only shown in the middle and large dose of TXL groups (P < 0.01). (3) In the model and the TXL groups, ET-1 mRNA expression in ischemic area was significantly higher (all P < 0.01), while it in no-reflow area was significantly lower than that in the normal area respectively (all P < 0.01). The raised ET-1 mRNA expression in the middle and large dose TXL groups was significantly lowered when compared with that in the model group (P < 0.01).</p><p><b>CONCLUSION</b>The endothelium injury might be one of the important mechanisms for no-reflow phenomenon. TXL might reduce the no-reflow by protecting endothelium cells. was significantly higher (all P < 0.01), while it in no-reflow area was significantly lower than that in the normal area respectively (all P < 0.01). The raised ET-1 mRNA expression in the middle and large dose TXL groups was significantly lowered when compared with that in the model group (P < 0.01). Conclusion The endothelium injury might be one of the important mechanisms for no-reflow phenomenon. TXL might reduce the no-reflow by protecting endothelium cells.</p>

Clinical study on spontaneous improvement after blood flow reconstruction interfered by tongxinluo capsule in patients with early stage acute myocardial infarction / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe and evaluate the effect of tongxinluo capsule (TXL) on recovery of ventricular wall with segmental dyskinesia in patients with early stage acute myocardial infarction (AMI).</p><p><b>METHODS</b>One hundred and twelve AMI patients after percutaneous coronary intervention (PCI) or fibrinolytic therapy, were randomly divided into 2 groups, the control group (CG) treated with conventional medicine and the interfered group (IG) treated with conventional medicine plus TXL. The changes of ventricular wall motion, left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were observed at different time points (1-w, 2-w, 1-m, 3-m and 6-m) after PCI by using two dimensional echocardiography (2DE).</p><p><b>RESULTS</b>The ventricular dyskinetic segment recovery rate at 1-w, 2-w, 1-m and 6-m in IG was 11.9%, 18.1%, 18.8% and 70.02% respectively, which was significantly higher than the respective rates in CG (4.1%, 8.3%, 11.1% and 51.68%, P < 0.01), but the 3-m recovery rate in the two groups was insignificantly different. LVEDV increase rate in the two groups at 1-w was insignificantly different, but it significantly increased at 2-w and 1-m, and showed a higher rate in CG (P < 0.05). However, at 3-m and 6-m, it significantly decreased in IG but was insignificantly changed in CG. Improvement of LVEF was insignificant at 1-w, 2-w and 1-m in both groups, but at 3-m and 6-m, LVEF was significantly improved in the interfered group (P < 0.01), but still showed no obvious change in the control group.</p><p><b>CONCLUSION</b>Conventional western medicine combined with TXL can significantly decrease the infarction area, improve left ventricular diastolic function in patients with AMI.</p>