[China coronary secondary prevention study: analysis of patients with different myocardial infarction history]
Bao-min Du1, Zong-liang Lu, Zuo Chen
1Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Scinence, Peking Union Medical College, Beijing 100037, China.
Insights
Xuezhikang capsule shows greater effectiveness in secondary prevention of coronary heart disease (CHD) for patients with a recent myocardial infarction (MI) history. Early treatment with Xuezhikang is recommended for improved CHD prevention outcomes.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Clinical Trials
Context:
- Secondary prevention of coronary heart disease (CHD) is crucial after myocardial infarction (MI).
- The efficacy of Xuezhikang, a traditional Chinese medicine, in post-MI patients requires further elucidation.
- Patient stratification based on the timing of MI history may influence treatment outcomes.
Purpose:
- To evaluate the effectiveness of Xuezhikang in secondary prevention of CHD.
- To compare the efficacy of Xuezhikang in patients with different durations of MI history (28 days-3 months vs. 3 months-60 months).
- To assess the impact of Xuezhikang on CHD events and all-cause mortality.
Summary:
- A randomized controlled trial involving 4870 patients with MI history compared Xuezhikang with placebo.
- Xuezhikang significantly reduced CHD events by 56.7% and all-cause mortality by 48.6% in patients with recent MI (28 days-3 months).
- In patients with longer MI history (3 months-60 months), Xuezhikang reduced CHD events by 35.3% but showed no significant reduction in all-cause mortality.
Impact:
- Xuezhikang demonstrates superior efficacy in the early secondary prevention of CHD following MI.
- The findings suggest that earlier intervention with Xuezhikang leads to better outcomes in preventing recurrent CHD events and mortality.
- This study supports the early use of Xuezhikang for patients with a history of myocardial infarction to enhance cardiovascular protection.
Objective:
To assess whether Xuezhikang was effective in the secondary prevention of coronary heart disease (CHD) for patients with different length of myocardial infarction (MI) history.
Methods:
2135 patients with MI history of 28 days to 3 months and 2735 patients with MI history of 3 months to 60 months were recruited separately to receive treatment with Xuezhikang capsule or placebo. The primary end-points were nonfatal myocardial infarction and death from CHD.
Results:
The occurrence of coronary events were found to be not statistically significantly different for the two groups of patients. For patients with MI history of 28 days to 3 months, Xuezhikang significantly reduced the risk of CHD events by 56.7% (P < 0.0001) and resulted in a 48.6% (P = 0.0002) risk reduction in all-cause mortality as compared with placebo. For patients with MI history of 3 months to 60 months, Xuezhikang significantly decreased the risk of CHD events by 35.3% (P = 0.0008) and led to a 20.0% (P = 0.1181) risk reduction in the all-cause mortality as compared with placebo. Adverse effects and abnormal laboratory parameters did not differ significantly in the two groups of patients.
Conclusions:
Xuezhikang is more effective for patients with MI history of 28 days to 3 months as compared with patients with MI history of 3 months to 60 months. Patients with MI history should be treated with Xuezhikang early in order to achieve better prevention of CHD.
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