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Complement use of Chinese herbal medicine after percutaneous coronary intervention: a prospective observational study
Si-Yu Yan1, Wei-Xian Yang1, Pei-Pei Lu1
1Chinese Academy of Medical Sciences & Peking Union Medical College Fuwai Hospital, Xicheng District, Beijing, China.
Insights
Chinese herbal medicine use after percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients was associated with a lower incidence of major adverse cardiovascular events (MACE). Further randomized studies are recommended to confirm these findings.
Area of Science:
- Cardiovascular Medicine
- Integrative Oncology
- Pharmacology
Background:
- Chinese herbal medicine is frequently used alongside conventional treatments for coronary artery disease (CAD) post-percutaneous coronary intervention (PCI).
- This study investigated the impact of Chinese herbal medicine on major adverse cardiovascular events (MACE) in CAD patients after PCI.
Purpose of the Study:
- To compare the incidence of MACE in CAD patients undergoing PCI, with and without the complementary use of Chinese herbal medicine.
Main Methods:
- A prospective, observational study followed 5453 patients for two years post-PCI.
- MACE (all-cause mortality, revascularization, myocardial infarction) was compared between patients using only Western medicine and those using Chinese herbal medicine adjunctively.
- Unadjusted and risk-adjusted analyses (Kaplan-Meier, multivariable Cox regression) were performed.
Main Results:
- The incidence of MACE was 15.3% in the Western medicine group and 11.54% in the integrative medicine group.
- Cox regression analysis revealed a 27% lower cumulative incidence of MACE in patients using Chinese herbal medicine (HR=0.73, P<0.0001).
Conclusions:
- Complementary use of Chinese herbal medicine in CAD patients after PCI is linked to reduced 2-year MACE incidence.
- Further randomized controlled trials are necessary to establish definitive evidence of benefit.
Background:
Chinese herbal medicine is widely used as a complement or alternative treatment in coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in China. We compared the incidence of the major adverse cardiovascular event (MACE) of CAD patients with or without the complement use of Chinese herbal medicine after PCI.
Methods:
In this prospective, observational study that was conducted from September 2016 to August 2019 in Fuwai Hospital (China), we followed up consecutive patients who received PCI treatment for two years. MACE was defined as the composite all-cause mortality, revascularization, and myocardial infarction (MI) and was compared between those using (integrative medicine group) or those not using Chinese herbal medicine as an additional treatment to standard Western medicine, with unadjusted (Kaplan-Meier curves) and risk-adjusted (multivariable Cox regression) analyses.
Results:
A total of 5942 patients after PCI were enrolled in this study, and 5453 patients were included in the final analysis (4189 [76.8%] male; mean age: 61.9 ± 9.9% years). During the follow-ups, 2932 (53.8%) patients used only Western medicine while 2521(46.2%) patients had used Chinese herbal medicine as an additional treatment to standard Western medicine. Patients in the integrative medicine group (IM group) were older than the Western medicine group (WM group), had more females and less previous MI. The incidence of MACE was 15.3% (449/2932) in WM group and 11.54% (291/2521) in IM group. Cox regression analysis showed that cumulative incidence of MACE was 27% lower in patients of the IM group than those in WM group (hazard ratio = 0.73; 95% CI: 0.63-0.85; P < 0.0001).
Conclusions:
For CAD patients after PCI treatment, complement use of Chinese herbal medicine is associated with a lower 2-year MACE incidence. Randomized prospective studies are warranted to provide higher levels of benefit evidence in these patients.
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