Ginsenoside Rg1 for ischemic heart disease injury: preclinical evidence and possible mechanisms

Ischemic heart disease (IHD) is the leading cause of global morbidity and mortality, underscoring an urgent need for innovative therapeutic strategies. Panax ginseng C. A. Meyer, a cornerstone herb in traditional medicine with exceptional pharmacological value, is widely regarded as the "King of Herbs". Ginsenoside Rg1 (G-Rg1), one of the principal bioactive protopanaxatriol-type saponins isolated from Panax ginseng C. A. Meyer, exhibits well-documented cardioprotective effects. However, a systematic and quantitative synthesis of its efficacy and mechanisms in preclinical IHD models is still lacking.

In this study, we conducted a preclinical systematic review to evaluate the efficacy of G-Rg1 in animal models of IHD and to synthesize current evidence on its underlying mechanisms. A search of four major biomedical databases from inception to May 2026 identified nine eligible studies (236 animals). Methodological quality, rigorously assessed using the 9-item CAMARADES checklist, yielded scores of 4 to 6, indicating moderate overall quality. Data were pooled and analyzed using RevMan 5.3.

Meta-analysis showed that G-Rg1 administration reduced myocardial infarct size and decreased plasma levels of cardiac injury biomarkers (creatine kinase-MB [CK-MB] and N-terminal pro-brain natriuretic peptide [NT-proBNP]), and improved key functional parameters. One study reported that G-Rg1 attenuated the inducibility of ventricular tachyarrhythmias following ischemia-reperfusion injury. Mechanistically, the cardioprotective effects of G-Rg1 were consistently associated with anti-inflammatory, anti-apoptotic and mitochondrial protection pathways.

These preclinical findings support future translational research and provide a basis for subsequent clinical studies on G-Rg1 in IHD.