The efficacy of Chinese herbal medicines on acute coronary syndrome with renal insufficiency after percutaneous coronary intervention.
J Ethnopharmacol
; 248: 112354, 2020 Feb 10.
Article
em En
| MEDLINE
| ID: mdl-31689480
ABSTRACT
ETHNOPHARMACOLOGICAL RELEVANCE Fufang Chuanxiong capsule consists of Angelica sinensis radix and Chuanxiong rhizome, which are used in the traditional Chinese medicine for the treatment of coronary artery disease, and Xinyue capsule is composed of panax quinquefolius saponin extracted from leaves and stems of Panax quinquefolium L, which has the functions of anti-myocardial ischemia, improving myocardial energy metabolism and inhibiting apoptosis of cardiomyocytes. OBJECTIVE:
To observe the role of Chinese herbal medicines in the cardiovascular outcome among patients with acute coronary syndrome (ACS) and renal insufficiency after percutaneous coronary intervention (PCI).METHODS:
The subjects came from the 5C trial (chictr.org number chictr-trc-07000021), post-PCI patients suffered from ACS with mild-to-moderate renal insufficiency (30â¯mLâ¢min-1â¢1.73â¯m-2â¯<â¯estimated glomerular filtration rate≤89â¯mLâ¢min-1â¢1.73â¯m-2) included. The study population consisted of 215 subjects in the control group who were treated with western medicine standard therapy, and 211 subjects in the treatment group who were treated with Chinese herbal medicines (Fufang Chuanxiong Capsule and Xinyue Capsule) for 6 months on the basis of western medicine standard therapy. All were followed for 1 year. The primary endpoint included the composite of cardiac death, nonfatal recurrent myocardial infarction, and ischemia-driven revascularization. Secondary endpoint included the composite of stroke, congestive heart failure, and readmission for ACS. The serum creatinine and estimated glomerular filtration rate (eGFR) were evaluated.RESULTS:
After 1 year follow-up of two groups, there were 16 cases of primary endpoint in the control group and 6 cases of primary endpoint in the treatment group [absolute risk reduction (ARR) 0.046, 95%CI 0.004-0.088; relative risk (RR) 0.38, 95%CI 0.15-0.96, Pâ¯=â¯0.040]. There were 15 cases of secondary endpoint in the control group and 5 cases of secondary endpoint in the treatment (ARR 0.041, 95%CI 0.006-0.086; RR 0.34, 95%CI 0.13-0.92, Pâ¯=â¯0.033). The eGFR in the treatment group was significantly higher than that in the control group (75.19⯱â¯16.74â¯mLâ¯min-1·1.73â¯m-2 VS 72.03⯱â¯14.96â¯mLâ¯min-1·1.73â¯m-2, Pâ¯<â¯0.05). The eGFR in the treatment group was significantly higher after the intervention with Chinese herbal medicines than that before intervention (72.27⯱â¯11.83â¯mLâ¯min-1·1.73â¯m-2 VS 75.19⯱â¯16.74â¯mLâ¯min-1·1.73â¯m-2, Pâ¯<â¯0.05).CONCLUSION:
Chinese herbal medicines plus western medicine standard therapy improved clinical outcomes in patients with ACS and mild-to-moderate renal insufficiency. Additionally, this study also demonstrated Chinese herbal medicines were useful in deferring decline of renal function.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Medicamentos de Ervas Chinesas
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Insuficiência Renal
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Síndrome Coronariana Aguda
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Intervenção Coronária Percutânea
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Taxa de Filtração Glomerular
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Rim
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
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Etiology_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article