Therapeutic effects of Guanxinping on carotid atherosclerosis: Modulation of inflammatory markers

Carotid atherosclerosis is a critical pathological basis of ischemic cardiovascular and cerebrovascular diseases, strongly associated with chronic inflammation. Inflammatory factors play a key role in plaque formation and instability. Current treatments have limitations in suppressing inflammation and stabilizing plaques. Guanxinping, a compound Chinese medicine, has demonstrated potential for cardiovascular protection through multi-target modulation, but its mechanisms remain unclear. This study evaluates the therapeutic effects of Guanxinping on patients with carotid atherosclerosis, focusing on its regulation of key inflammatory factors, impact on carotid intima-media thickness (IMT), plaque scores, and vascular elasticity, and to explore the mediating role of inflammatory factors in its efficacy. A propensity score-matched design was adopted, including patients receiving Guanxinping combined with conventional treatment (experimental group, n = 53) and conventional treatment alone (control group, n = 53). IMT, plaque scores, and vascular elasticity were assessed by ultrasound, inflammatory factors were measured using enzyme-linked immunosorbent assay, and mediation analysis was conducted using structural equation modeling. Guanxinping significantly reduced IMT (1.1 ± 0.1 mm vs 1.2 ± 0.2 mm, P = .03) and plaque scores (3.2 ± 1.0 vs 3.8 ± 1.1, P = .02) while improving vascular elasticity indicators (β-value, Ep value, and AC value; P = .01, P = .02, and P = .03, respectively). Serum levels of inflammatory factors (C-reactive protein, interleukin (IL)-6, tumor necrosis factor-alpha, IL-1β, IL-18, and Caspase-1) were significantly lower in the experimental group compared to the control group (all P < .05). IL-1β and IL-18 mediated 40.5% and 41.2% of the effects on IMT and plaque score improvement, respectively. Guanxinping significantly improves IMT and plaque scores, suppresses key inflammatory factors, and enhances plaque stability through mult-itarget mechanisms. These findings provide new insights into its use in integrative treatments for cardiovascular diseases and lay a foundation for precision medicine strategies.