Traditional Chinese Medicine Treatment for Coronary Heart Disease: Pathological Mechanisms of Modulating Cell Death...

Coronary heart disease (CHD) is one of the most prevalent cardiovascular pathologies, with complications significantly increasing mortality rates. The pathogenesis of CHD is complex and multidimensional, and its cellular and molecular basis remains incompletely understood. Recent studies indicate that multiple forms of cell death participate in the initiation and progression of CHD, including inflammation-driven factors (Pyroptosis- Necroptosis- Ferroptosis), context-dependent modulators (Apoptosis- Autophagy), and emerging/hypothetical mechanisms (PANoptosis- Cuproptosis- Disulfidptosis). Meanwhile, traditional Chinese medicine (TCM) is gaining increasing attention in the management of cardiovascular diseases, particularly CHD. This research summarizes the roles of multiple cell death pathways in the pathogenesis of CHD and provides a detailed review and comprehensive analysis of the mechanisms underlying existing experimental studies on TCM formulas and active components used to treat CHD. We highlight representative TCM metabolites and TCM formulas, such as resveratrol, TongMai YangXin Wan, Gualoupi Injection, etc. It concludes that TCM counteracts CHD by inhibiting various cell death pathways. Current basic research primarily focuses on signaling pathways such as PI3K/Akt, TNF, and MAPK. This work provides new insights and approaches for the treatment of CHD and further research. Finally, it identifies current challenges, including unclear compositions of TCM and insufficient validation of mechanisms, and proposes new directions for future research.