Abstract

BackgroundTo assess the efficacy and safety of oral Guanxinshutong (GXST) capsules in Chinese patients with stable angina pectoris (SAP) in a prospective, multicenter, double-Blind, placebo-controlled, randomized clinical trial (clinicaltrials.gov Identifier: NCT02280850).MethodsEligible patients were randomized 1:1 to the GXST or placebo group. Current standard antianginal treatment except for nitrate drugs was continued in both groups, who received an additional 4-week treatment of GXST capsule or placebo. Primary endpoint was the change from baseline in angina attack frequency after the 4-week treatment. Secondary endpoints included the reduction of nitroglycerin dose, score of Seatntle Agina Questionnaire, exercise tolerance test defined as time to onset of chest pain and ST-segment depression at least 1 mm greater than the resting one.ResultsA total of 300 SAP patients from 12 centers in China were enrolled between January 2013 and October 2015, and they were randomly divided into the GXST group and the placebo group (150 patients in each group). Of whom, 287 patients completed the study (143 patients in the GXST group, 144 patients in the placebo group). The baseline characteristics of the two groups were comparable. After 4-week treatment with GXST capsules, the number of angina attacks and the consumption of short-acting nitrates were significantly reduced. In addition, the quality of life of patients were also substantially improved in the GXST group. No significant differences in the time of onset of angina and 1-mm ST segment depression were noted between the two groups. 7 patients (4.1%) in the GXST group and 3 patients (2.1%) in the placebo group reported at least one adverse event, respectively.ConclusionsGXST capsules are beneficial for the treatment of SAP patients.

Highlights

  • To assess the efficacy and safety of oral Guanxinshutong (GXST) capsules in Chinese patients with stable angina pectoris (SAP) in a prospective, multicenter, double-Blind, placebo-controlled, randomized clinical trial

  • According to guidelines published by the health authorities of the United States [3], Canada [4], Europe [5] and China [6], the current treatment for SAP relies on the use of anti-ischemic drugs, such as nitrates, β-blockers, calcium channel blockers (CCB), angiotensin converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB), and is often combined with secondary prevention measures such as lipid lowering and antiplatelet drugs to prevent myocardial infarction and death, reduce the symptoms of ischemic attack and improve the quality of life (QOL) of patients [7, 8]

  • We found that the number of weekly anginal attacks and nitroglycerin consumption with GXST capsule treatment were significantly reduced in comparison with placebo

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Summary

Introduction

To assess the efficacy and safety of oral Guanxinshutong (GXST) capsules in Chinese patients with stable angina pectoris (SAP) in a prospective, multicenter, double-Blind, placebo-controlled, randomized clinical trial (clinicaltrials.gov Identifier: NCT02280850). Stable angina pectoris (SAP) is one of the most common subtypes of coronary heart disease, and it affects approximately 54 million patients worldwide [1, 2]. Traditional Chinese medicine has been used in the treatment of chronic heart disease for more than 2000 years in China [9,10,11]. Animal experiments in rats have shown that GXST capsules can increase coronary blood flow, improve myocardial oxygen supply, and regulate vascular compliance [12, 13]. A clinical observational study has shown that GXST capsules are effective and safe for the treatment of SAP patients [14]. The efficacy of the drug has not been established by well-designed randomized clinical trials in China

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