Coronary Heart Disease Angina Research Articles

Incidence of coronary heart disease among remote workers: a nationwide web-based cohort study

Coronary heart disease (CHD) risk is influenced by socioeconomic status-related parameters, particularly occupation. We investigated occupational gaps in CHD risk and how the introduction of remote work moderated the observed occupational differences in CHD risk during the coronavirus disease 2019 pandemic in Japan. Data from a web-based, nationwide cohort study, comprising 17,640 workers (aged 20–65 years) with baseline data from December 2020, were analyzed. Participants were grouped by occupation as upper-level nonmanual workers (managers/professionals) and others (reference group). The primary outcome was CHD (angina pectoris/myocardial infarction) onset retrospectively confirmed at the 1-year follow-up survey. Upper-level nonmanual workers exhibited a higher CHD incidence than others (2.3% vs. 1.7%). This association was pronounced in the younger (20–49 years) population, with a significant CHD risk (adjusted risk ratio = 1.88). Upper-level nonmanual workers exhibited nearly 15% higher remote work prevalence, with a significant remote work-related CHD risk (adjusted risk ratio = 1.92). The mediating effects of remote work explained an overall disparity of 32% among the younger population. Occupational gaps in CHD incidence in Japan differ from those in Western countries, where upper-level nonmanual workers have lower cardiovascular risk. In Japan, remote work can mediate CHD risk in the younger population of upper-level nonmanual workers.

Efficacy and safety of tongxinluo capsule for angina pectoris of coronary heart disease: an overview of systematic reviews and meta-analysis.

Tongxinluo capsule (TXLC) is a common drug for treating angina pectoris of coronary heart disease (CHD). In recent years, many systematic reviews (SRs) and meta-analyses (MAs) have reported the efficacy and safety of TXLC for improving angina symptoms in patients with CHD. We aimed to comprehensively evaluate the existing SRs and MAs of TXLC in treating angina pectoris of CHD, summarize the evidence quality, and provide scientific evidence and recommendations. We searched seven databases for relevant SRs/MAs published up to 1 June 2023. Two reviewers independently completed the literature retrieval, screening, and data extraction. We used A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2) to evaluate the methodological quality, the Risk of Bias in Systematic Reviews (ROBIS) to assess the risk of bias, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) to determine the strength of the evidence. RevMan 5.3 was used to synthesize data. We identified 15 SRs/MAs, including 329 RCTs and 33,417 patients. According to the evaluation results of AMSTAR-2, only one SR was of high methodological quality, the others were very low. ROBIS assessment showed that one SR (6.67%) had a low risk, 3 SRs (20%) had an unclear risk, and 11 SRs (73.33%) had a high risk. We assessed 42 outcomes by the GRADE, 10 (23.81%) for moderate-quality evidence, 17 (40.48%) for low-quality evidence, and 15 (35.71%) for very-low-quality evidence. Mate-analysis showed that TXLC combined with conventional western medications improved electrocardiogram efficacy (RR = 1.38, 95% CI: 1.23-1.43, P < 0.001) and angina efficacy (OR = 3.58, 95% CI: 3.02-4.24, P < 0.001), reduced angina attack frequency (SMD = -0.54, 95% CI: -0.64 to -0.44, P < 0.001) and angina duration (SMD = -0.42, 95% CI: -0.57 to -0.28, P < 0.001), with general heterogeneity. The pooled results showed that TXLC appears to have some efficacy in improving cardiac function and relieving angina symptoms, but there is limited evidence that it improves cardiovascular event rates, hemorheology, lipids, or hs-CRP. In the assessment of drug safety, TXLC was associated with different degrees of adverse drug reactions. Based on the evidence, TXLC may be effective as an adjuvant treatment for angina pectoris of CHD. However, the quality of the evidence is low, and the drug's safety must be carefully interpreted. In future studies, high-quality randomized controlled trials are needed to confirm the effectiveness and safety of TXLC. http://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022365372).

Mechanism Investigation of Tianxiangdan Against Myocardial Ischemia Based on Network Pharmacology, Molecular Docking, and in vitro Experimental

Objectives: Tianxiangdan capsule (TXD) has been clinically used in the treatment of coronary heart disease angina pectoris. This study aimed to evaluate the mechanisms of TXD against myocardial ischemia and provide evidence for its subsequent clinical application. Materials and Methods: Active components and mechanisms of action of TXD against myocardial ischemia were predicted and analyzed by network pharmacology and molecular docking. The chemical constituents in TXD were determined by HPLC-MS. The oxidative damage model was established using H2O2, which caused myocardial ischemia damage. The MTT assay and Hoechst 33342 staining were used to evaluate cell viability, while cleaved caspase-3 immunofluorescence staining was used to determine cell apoptosis. The fluorescent probe method detected ROS and intracellular Ca2+, while spectrophotometry was used to measure SOD, MDA, and NO levels in myocardial cells. Western blotting was used to detect the expression levels of ERɑ, PI3K, p-PI3K, AKT, p-AKT, and eNOS in cells. Results: It was found that TXD plays a protective role in myocardial ischemia through the estrogen pathway. The TXD drug-containing plasma exhibited increased cell survival rates and suppressed MDA levels, elevated SOD and NO levels, and significantly suppressed ROS levels as well as intracellular Ca2+ levels. Moreover, the TXD drug-containing plasma pretreated cells had significantly suppressed PI3K, p-PI3K, AKT, and p-AKT expression levels, as well as elevated ERɑ and eNOS expression levels. Conclusion: TXD activates estrogen receptor ERɑ, enhances NO release of cardiomyocytes through the estrogen signaling pathway, improves intracellular Ca2+ overload, oxidative stress injury, and apoptosis, and plays a protective role in myocardial ischemia injury.

Evidence quality assessment of sodium tanshinone IIA sulfonate injection intervention coronary heart disease angina pectoris: An overview of systematic reviews and meta-analyses.

Sodium tanshinone IIA sulfonate injection (STS) is widely used in the clinical treatment of coronary heart disease angina pectoris (CHDAP). This article systematically summarizes and evaluates the available evidence for STS in the treatment of AP, and assess its quality. Two researchers searched and extracted 8 databases for systematic reviews (SRs)/meta-analyses (MAs), and independently assessed the methodological quality, risk of bias, reporting quality, and quality of evidence of SRs/MAs included in randomized controlled trials (RCTs). Tools used included the Assessment of Multiple Systematic Reviews 2 (AMSTAR-2), the risk of bias in systematic (ROBIS) scale, the list of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. This overview includes 11 SRs/MAs that use quantitative calculations to comprehensively evaluate various efficacies of STS in AP intervention. The methodological quality, reporting quality, risk of bias, and quality of evidence for outcome measures of SRs/MAs were all unsatisfactory. All SRs/MAs are of low quality according to the results of the AMSTAR-2 assessment, and only a small number of SRs/MAs were assessed as low risk of bias based on the results of the ROBIS assessment, and none of the SRs/MAs has been fully reported on the checklist. According to GRADE system, 33 outcomes were extracted from the included SRs/MAs for evaluation, of which 12 were rated as moderate-quality evidence, 7 as low-quality evidence, and 14 as very low-quality evidence. Limitations included the lack of essential items such as protocol registration, screening of duplicate studies, provision of a list of excluded studies and assessment of publication bias. Tanshinone IIA Sulfonate Sodium Injection may be an effective and safe treatment method. However, further standardized, comprehensive SRs/MAs and RCTs are needed to provide evidence-based medical support.

Clinical Efficacy of Tongxinluo Capsule Combined with Nutritional Support on Coronary Heart Disease Angina Pectoris

This study aimed to explore the impact of the Tongxinluo capsule combined with nutritional support on the clinical efficacy and nutritional status of patients with coronary heart disease angina pectoris. A total of 118 patients admitted to our hospital between August 2022 and May 2023 were divided into a control group and an observation group. Patients in the control group underwent routine treatment and nutritional interventions. Patients in the observation group received Tongxinluo capsules and tailored nutritional treatments. The observation group had a higher total effective rate, left ventricular ejection fraction, and high-density lipoprotein cholesterol level than the control group. Conversely, it had lower left ventricular end-systolic diameter, left ventricular end-diastolic diameter, total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels compared to the control group. Interleukin-6, tumor necrosis factor α, hypersensitive C-reactive protein levels, plasma viscosity, hematocrit, high-cut whole blood viscosity, fibrinogen level, and body mass index of the observation group were also lower than the control group. The incidence of adverse reactions between the two groups was not significant (P &gt; 0.05). Tongxinluo capsule, combined with nutritional support effectively and safely treats coronary heart disease angina pectoris and can improve patients’ cardiac function index.

Research Review of Acupoint Application Therapy of Traditional Chinese Medicine in the Treatment of Coronary Heart Disease and Angina Pectoris

The Coronary heart disease angina pectoris belongs to the comprehensive lesion of multiple factors and multiple syndrome, with complex pathogenesis. Western medicine mainly uses drug treatment, with clear targets, improving the single index is significant, but it is easy to produce toxic side effects and drug resistance. Traditional Chinese medicine under the guidance of overall concept and syndrome differentiation theory, combined with modern medical achievements, multiple targets, multi-way treatment of coronary heart disease angina clinical curative effect, make up for the shortage of western medicine single target, single treatment, reduce the western medicine side effects and reduce drug resistance, effectively improve patients with clinical symptoms and prognosis, improve the quality of life, prolong survival. Traditional Chinese medicine characteristic therapy has certain unique in the treatment of coronary heart disease, simple and easy to do and no side effects, and can reduce medical expenses, is a suitable treatment method for patients with coronary heart disease. Modern medical research shows that acupoint application can make the drug ingredients through the skin, orifice, acupoints absorption direct disease, warm the meridians, mobilize the function of the meridians; medicine can follow the meridians into the viscera, to adjust the viscera, dredge Qi and blood, so that it better play the overall role of Qi and blood, Yin and Yang. Many clinical studies have confirmed that TCM acupoint application therapy is widely used in clinical practice. Due to its simple clinical operation, safety and high patient comfort, and high patient acceptance and compliance, it is accepted by clinical departments and patients. In clinical application, TCM acupoint application therapy can effectively improve the clinical symptoms of angina pectoris, improve electrocardiogram and improve the quality of life of patients, which is worthy of clinical promotion and application. In this paper, the current situation of the treatment of coronary heart disease angina pectoris is summarized, so as to facilitate the clinical promotion and application.

Treatment of coronary heart disease angina pectoris from the five internal organs

Treatment of coronary heart disease angina pectoris from the five internal organs

Yangxin decoction for the treatment of angina pectoris of coronary heart disease: A systematic review of randomized controlled trial.

Background:This study assessed the effectiveness of Yangxin Decoction (YXD) in the treatment of coronary heart disease (CHD) patients with angina pectoris (AP).Methods:In this study, we systematically and comprehensively searched the PUBMED, EMBASE, Cochrane Library, CNKI, WANGFANG, and VIP databases from their establishment to June 1, 2022. Clinical randomized controlled trials of YXD for the management of AP in patients with CHD were considered for inclusion. The outcomes included the response rate of AP, response rate based on electrocardiogram, and the rate of nitroglycerin use. Two authors independently performed literature selection, data extraction, and methodological quality assessment. Any differences were resolved by a third author through a discussion.Results:Nine trials involving 819 patients were included. The meta-analysis results showed that YXD significantly improved the response rate of AP (OR = 2.98, 95% CI: 1.96–4.55, I2 = 0%, P < .01) and the response rate based on the electrocardiogram (OR = 1.88, 95% CI: 1.28–2.78, I2 = 26%, P < .01), and significantly reduced the rate of nitroglycerin use (OR = 2.04, 95% CI: 1.19–3.52, I2 = 0%, P = .01).Conclusions:The results of this study showed that YXD was effective in the treatment of patients with AP of CHD. Further studies are required to confirm these results.

Time-dependent effects of metoprolol in patients with coronary heart disease and grade II–III angina pectoris

BACKGROUND: This study focused on the topical problem of studying the time-dependent effects of the cardioselective -adrenergic receptor blocking agent metoprolol in patients with coronary heart disease (CHD) and grade IIIII angina pectoris.&#x0D; AIM: This study aimed to analyze the effect of metoprolol when used at different times of the day based on the concept of chronopharmacology, which is based on the variability of adrenoreceptor sensitivity depending on the day-night cycle.&#x0D; MATERIALS AND METHODS: Acute clinical and pharmacological tests were performed in 20 patients with CHD and grade IIIII angina pectoris to determine the time-dependent effects of metoprolol. All patients underwent a study of the parameters of central and peripheral hemodynamics, as well as electrocardiography and echocardiography. The study results were subjected to statistical analysis.&#x0D; RESULTS: Metoprolol at 100 mg at different hours of the day causes a persistent negative chrono- and inotropic, hypotensive effect. The clinical and pharmacological test results registered the listed effects with favorable shifts in the first instance when taking the drug in the morning and midday hours. Circadian rhythms of sensitivity of several indicators of the cardiovascular system to metoprolol have been established.&#x0D; CONCLUSIONS: The study results on the time-dependent hemodynamic effects of metoprolol using acute pharmacological tests enabled to establish the presence of a circadian organization of several hemodynamic parameters with an acrophase of sensitivity to metoprolol at 15:00 and 14:00 h.

Remnant cholesterol for the detection of glucose metabolic states in patients with coronary heart disease angina pectoris.

This study aimed to evaluate the relationship between remnant cholesterol (RC) and glucose metabolic states in coronary heart disease (CHD) patients with angina pectoris. This study collected data from 11,557 CHD patients with angina pectoris aged 35-75years in Tianjin, China. Participants were divided into normal glucose regulation (NGR), prediabetes (Pre-DM) and diabetes mellitus (DM) groups according to glucose metabolic states. Linear regression analysis was used to explore the relationship between glucose metabolism [fasting blood glucose (FBG) and glycated hemoglobin (HbA1c)] and RC levels. Logistic regression was performed to analyze the relationship between RC levels and glucose metabolic states. Among all participants, 5883 (50.9%) had a DM state and 4034 (34.9%) had a Pre-DM state. FBG levels and HbA1c levels were positively related with RC in all patients (P < 0.001). NGR was used as a reference, multi-adjusted model showing that RC level was significantly associated with Pre-DM [Odds ratio (OR): 1.37; 95% confidence interval (CI) 1.19-1.56; P < 0.001] and DM state (OR:1.47; 95% CI 1.29-1.67; P < 0.001). When considering RC as categorical variables (tertiles), using T1 as a reference, T3 had the strongest relationship between RC levels and Pre-DM and DM state in univariate model and multivariate model. In the stratified analyses, the association between RC levels and pre-DM and DM in women was higher than that in men, and the elderly patients was higher than in the middle-aged patients. The study demonstrated a significant association between RC levels and pre-DM and DM state among CHD patients with angina pectoris, and the relationship was stronger in women and elderly patients.

Effects of adjuvant Chinese patent medicine therapy on major adverse cardiovascular events in patients with coronary heart disease angina pectoris: a population-based retrospective cohort study

Abstract Objective: This study aimed to explore the effects of Chinese patent medicine (CPM) in reducing the incidence of major adverse cardiovascular events (MACE) in patients with coronary heart disease (CHD) angina pectoris and improving clinical effectiveness and provide evidence for its use as clinical adjuvant therapy. Methods: Twenty-eight thousand five hundred and seventeen patients hospitalized with CHD angina pectoris from 6 hospitals were divided into CPM group (n = 11,374) and non-CPM group (n = 17,143) to evaluate the incidence of MACE, including myocardial infarction, percutaneous coronary intervention, and coronary artery bypass grafting. Results: The incidence of MACE in the CPM group was lower than that in the non-CPM group. CPM therapy was an independent protective factor that reduced the overall risk of MACE [adjusted hazard ratio = 0.40, 95% confidence interval (0.33; 0.49)]. Patients in the CPM group who received one, two, or three types of CPM could benefit from adjuvant treatment with CPM, and taking more types of CPM was associated with a lower risk of MACE. In addition, the male population was better than the female population in taking CPM, and middle-aged people aged 55 to 64 were more suited to take CPM based on Western medicine. Conclusions: The use of CPM as adjuvant therapy can decrease the occurrence of MACE in patients with CHD angina pectoris, especially in men and middle-aged people, and the drug treatment plan should be optimized accordingly. However, this conclusion needs further verification by prospective cohort studies in the future.

Meta-Analysis of the Effect of Honghua Injection in the Treatment of Coronary Heart Disease Angina Pectoris.

Objective To evaluate the effectiveness of honghua injection combined with western medicine in the treatment of coronary heart disease angina pectoris. Methods Computer extensively searched PubMed, Cochrane Library, Embase, China Biomedical Archives (SinoMed), China Knowledge Network (CNKI), Chinese Journal Full-text Database (VIP), Wanfang Data Knowledge Service Platform (Wanfang), and collected randomized controlled trials (RCTs) of honghua injection combined with western medicine in the treatment of coronary heart disease angina pectoris. Use Review Manager5.3 software for meta-analysis. Results 21 RCTs were included, involving 1894 participants. Meta-analysis shows that honghua injection combined with western medicine can significantly improve the clinical efficacy (OR = 4.03, 95% CI[2.96,5.49]), electrocardiographic efficacy (OR = 3.39, 95%CI[2.44, 4.70]), can significantly reduce total cholesterol (TC) levels (MD = −0.39, 95% CI[−0.47, −0.31]), triacylglycerol (TG) levels (MD = −0.45, 95% CI[−0.51, −0.39]), increase high-density lipoprotein cholesterol (HDL-C) levels (MD = 0.29,95%CI[0.26,0.32]), reduce low-density lipoprotein Cholesterol (LDL-C) levels (MD = −0.59, 95%CI[−0.79, −0.38]). Five articles reported adverse reactions. Conclusion Honghua injection combined with western medicine is more effective than western medicine alone in patients with coronary heart disease angina pectoris. More multicenter, large sample, high-quality RCTs are needed to provide evidence.

Perioperative coronary artery spasm after off-pump coronary artery bypass grafting in the non-manipulated coronary artery

BackgroundPerioperative coronary artery spasm (CAS) following coronary artery bypass grafting (CABG) is a severe or lethal condition that is rarely reported. In addition, rare cases with CAS following CABG in the non-manipulated coronary artery are angiographically documented in the perioperative period. We aimed to report our experiences on the diagnosis and treatment of a case with CAS following off-pump CABG in the non-manipulated coronary artery.MethodsA 57-year old male with coronary heart disease and unstable angina willing to undergo CABG was admitted to our department. CABG was recommended as he showed 90% stenosis in distal left anterior descending artery, 90% stenosis in intermediate branch, 90% stenosis in left circumflex coronary artery, as well as 50% stenosis in proximal right coronary artery (RCA).ResultsAfter CABG, the patient showed Adams–Stokes syndrome and ST-segment elevation. Then CPR was conducted and coronary angiography indicated perioperative CAS in the non-manipulated posterior descending artery. For the treatment, the patient received nitroglycerin injection into the coronary artery by catheter and pumping of diltiazem. Finally, the patient was discharged on day 7 after surgery. A comprehensive literature search was conducted to summarize the studies focused on the diagnosis and treatment of such condition, which indicated that all of the CAS cases occurred in the manipulated vessels, except one study showing CAS in the untouched native coronary artery which was similar with our case.ConclusionsPerioperative CAS in the non-manipulated coronary artery following CABG is a severe or lethal condition that is rarely reported, which deserves close attention by the clinicians in clinical practice.

Clinical comprehensive evaluation of Guanxin Shutong Capsules in treatment of coronary heart disease angina pectoris with heart blood stasis syndrome

This study aims to comprehensively summarize articles on the treatment of coronary heart disease angina pectoris with heart blood stasis syndrome(CHD-AP-HBSS) by Guanxin Shutong Capsules(GSC), and comprehensively evaluate the evidence and value of the formula in &quot;6+1&quot; dimensions based on multi-criteria decision analysis(MCDA) model and Guidelines for Management of Comprehensive Clinical Evaluation of Drugs(trial version 2021) with quantitative and qualitative methods, which is expected to highlight the clinical characteristics and advantages of the prescription and serve as a reference for medical and health departments. The dimensions are grade A, B, C, or D. In terms of safety, according to the reports from the spontaneous reporting system of National Center for ADR Monitoring, and literature analysis, GSC mainly results in the adverse reactions of mild or moderate nausea, diarrhea, rash, palpitation, and headache, with favorable prognosis in patients. Nevertheless, severe adverse reactions have been reported after marketing. Thus, additional evidence for its safety should be accumulated, and the current safety is grade B. Meta-analysis proves that GSC in combination with conventional treatment is superior to conventional treatment alone in alleviating AP and symptoms indicated by electrocardiogram(ECG). Therefore, the effectiveness of the medicine is grade A. As for the pharmacoeconomic value, based on the assumption that the per capita disposable income in 2020 is the willingness-to-pay threshold, it is more economical for CHD-AP patients to use GSC combined with conventional treatment than conventional treatment alone. However, as the currently available clinical parameters fail to support the difference in indirect cost between the two groups, the accuracy in the cost of intervention plan needs to be further improved. Therefore, the economy of the prescription is grade B. GSC has been awarded 13 national invention patents and 1 utility model patent, and won a lot of national and provincial patent awards, marking the enterprise service awareness and innovativeness. As a result, it is grade A in aspect of innovation. A questionnaire on the suitability of GSC suggests that publicity and promotion influence patients' choice and thus additional efforts should be made in this aspect. The suitability of this formula is grade B. Both rural and urban residents can afford the medicine for the whole course and the price is close to that of similar Chinese patent medicines. In addition, it is accessible regardless of season and place, so accessibility is grade A. As a Mongolian empirical formula destined to treat heart stabbing pain, it has the effects of activating blood and resolving stasis, dredging channels and activating collaterals, and moving Qi to relieve pain, and boasts the empirical evidence of more than 2 000 human cases. With prominent characteristics of traditional Chinese medicine, it is grade B. Based on the MCDA model and CSC v2.0, GSC is comprehensively class A in the treatment of CHD-AP-HBSS. The result can serve as a reference for basic clinical medication management.

Effects and Mechanisms of Taohong Siwu Decoction on the Prevention and Treatment of Myocardial Injury.

Taohong Siwu decoction (THSWD) is one of the classic prescriptions for promoting blood circulation and removing blood stasis. With the continuous in-depth excavation in basic and clinical research, it has been found that THSWD has made greater progress in the prevention and treatment of cardiovascular diseases. Mechanisms of the current studies have shown that it could prevent and treat the myocardial injury by inhibiting inflammatory reaction, antioxidant stress, inhibiting platelet aggregation, prolonging clotting time, anti-fibrosis, reducing blood lipids, anti-atherosclerosis, improving hemorheology and vascular pathological changes, regulating related signal pathways and other mechanisms to prevent and treat the myocardial injury, so as to protect cardiomyocytes and improve cardiac function. Many clinical studies have shown that THSWD is effective in the prevention and treatment of cardiovascular diseases related to myocardial injuries, such as coronary heart disease angina pectoris (CHD-AP), and myocardial infarction. In clinical practice, it is often used by adding and subtracting prescriptions, the combination of compound prescriptions and combinations of chemicals and so on. However, there are some limitations and uncertainties in both basic and clinical research of prescriptions. According to the current research, although the molecular biological mechanism of various active ingredients needs to be further clarified, and the composition and dose of the drug have not been standardized and quantified, this study still has exploration for scientific research and clinical practice. Therefore, this review mainly discusses the basic mechanisms and clinical applications of THSWD in the prevention and treatment of the myocardial injury caused by CHD-AP and myocardial infarction. The authors hope to provide valuable ideas and references for researchers and clinicians.

Research progress in drug therapy of coronary heart disease and angina pectoris

Coronary heart disease angina pectoris is a common symptom of coronary heart disease, which is mainly caused by patients' coronary artery hardening to varying degrees and abnormal blood flow, resulting in sudden intermittent sharp pain in the chest, which has a great impact on the life and health of patients. At present, there are many drugs for the treatment of coronary heart disease and angina pectoris. Western drugs include nitrates, calcium antagonists β Receptor blockers, statins. Traditional Chinese medicine includes drugs for removing blood stasis and excess, drugs for promoting blood circulation and tonifying deficiency, etc. The efficacy and indications of each drug are different. This paper reviews the literature on the drug treatment of coronary heart disease and angina pectoris.

Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of angina pectoris of coronary heart disease (CHD): A protocol for systematic review and meta analysis.

Background:Coronary heart disease (CHD) angina pectoris is a clinical syndrome in which episodic chest pain or chest discomfort is the main manifestation of temporary ischemia and hypoxia of the myocardium due to coronary atherosclerosis and coronary artery functional changes (spasm). A large amount of clinical evidence confirms that acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris can relieve the symptoms of angina pectoris and improve the performance of electrocardiograph ischemia; It still has obvious therapeutic effects in regulating the levels of cardiovascular regulatory peptides ET and cGRP. To better evaluate the effectiveness and safety of acupuncture combined with Chinese herbal medicine in the treatment of CHD and angina pectoris, we designed a systematic evaluation program to provide a reliable scientific basis for the future use of this method.Methods:Search Pubmed database, Embase, Cochrane library, Chinese Biomedical Literature CD-ROM Database (CBMdisk), China Journal Network Full-text Database (CNKI), Wanfang Database, Web of Science (SCI-E), the retrieval time is established from each database Until October 2021, search for relevant eligible randomized controlled trials with keywords or subject terms “acupuncture”, “Chinese herbal medicine”, and “CHD angina”. Outcome indicators were clinical symptoms of CHD and angina pectoris, changes in electrocardiogram, changes in blood lipids, and significant improvement in traditional Chinese medicine syndromes before and after treatment. Two researchers independently carried out data extraction and quality assessment, and use RevMan5.3 software to carry out final data analysis and assessment.Results:This study provides a reliable clinical scientific basis for acupuncture combined with Chinese herbal medicine for the treatment of CHD and angina pectoris.Conclusion:Acupuncture combined with Chinese herbal medicine can effectively relieve the clinical symptoms of CHD and angina pectoris and improve the performance of electrocardiograph. At the same time, it can reduce the cardiovascular regulatory peptide ET and increase the level of cGRP in the patient's plasma, thus confirming its effectiveness and safety.

Clinical comprehensive evaluation of Naoxintong Capsules in treatment of cerebral infarction with Qi deficiency and blood stasis syndrome and coronary heart disease angina pectoris

Through investigating the current research on the effect of Naoxintong Capsules in the treatment of cerebral infarction with Qi deficiency and blood stasis syndrome and coronary heart disease angina pectoris, this study conducted a clinical comprehensive evaluation in &quot;6+1&quot; dimensions [safety, effectiveness, economy, innovation, suitability, accessibility, and characteristics of traditional Chinese medicine(TCM)], so as to highlight the advantages and clinical value of Naoxintong Capsules. By combining qualitative and quantitative methods, we used the multi-criteria decision analysis(MCDA) model to measure each dimension, and the results thereby were divided into four grades of A, B, C, and D in high-to-low order. Through literature review and evaluation, the adverse effects of Naoxintong Capsules are mainly caused by the gastrointestinal system. Since the safety risk is controllable based on current research, the safety evaluation is grade B. The effectiveness of Naoxintong Capsules combined with conventional western medicine in the treatment of cerebral infarction with Qi deficiency and blood stasis syndrome and coronary heart disease angina pectoris is evaluated as grade A, as compared with conventional therapy alone. The economy of Naoxintong Capsules, compared with Tongxinluo Capsules, is assessed as grade B. According to literature reports, Naoxintong Capsules exhibits outstanding clinical innovation in optimizing the current anti-platelet therapy strategy for patients with coronary heart disease after percutaneous coronary intervention(PCI), and the innovation is class A. Given the capsule formulation is convenient for storage and transportation, and its usage is easy for patients to grasp and accept, the suitability is grade B. The accessibility is grade A considering the price level, availability, and affordability, and the characteristics of TCM are evaluated as grade A from the perspectives of theoretical characteristics and human experience. The results of the comprehensive drug evaluation showed that the clinical value of Naoxintong Capsules is class A for treating cerebral infarction with Qi deficiency and blood stasis syndrome and coronary heart disease angina pectoris. According to the Guidelines for the Management of Comprehensive Clinical Evaluation of Drugs(trial 2021 version) issued by the National Health Commission, relevant policy results for basic clinical drug management can be formulated directly by procedure.

Efficacy and safety of Xinkeshu in the treatment of angina pectoris of coronary heart disease: A protocol for systematic review and meta-analysis.

Background:The incidence of angina pectoris (AP) of coronary heart disease (CHD) is increasing in the world, which seriously affects people's lives and brings a huge economic burden. The clinical research on Xinkeshu (XKS) in the treatment of AP of CHD has been increasing. However, there is no systematic review and meta-analysis. This study intends to provide a basis for systematically evaluating the efficacy and safety of XKS combined with conventional western medicine in the treatment of AP of CHD.Methods:CNKI, Wanfang, VIP, Web of Science, PubMed, Cochrane Library, and EMbase databases were searched for the period from the establishment of the database to August 31, 2021. The clinical randomized controlled trials of XKS in the treatment of AP of CHD were collected. Two systematic reviewers independently selected the literature, extracted the data, and evaluated the quality according to the inclusion and exclusion criteria. The methodological quality of the literature was evaluated using Cochrane Handbook 5.3.0 bias risk assessment tool, RevMan 5.3.0 software was used for meta-analysis and GRADE3.6 evidence quality grading system was used to evaluate the quality.Results:This study intended to evaluate the efficacy and safety of XKS in the treatment of AP of CHD from many aspects, including the frequency of AP, the duration of AP, the dosage of nitroglycerin, and the efficacy of ECG (total effective rate = markedly effective + effective). The secondary indicators included the efficacy of AP (total effective rate = significant + effective), blood lipids (triglyceride, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol), hemorheology (whole blood viscosity, plasma viscosity, and fibrinogen), serum factors (C-reactive protein, endothelin-1, homocysteine, and nitric oxide), and adverse drug reactions.Conclusion:The conclusion of the systematic review intended to provide clear evidence of clinical application of XKS combined with conventional western medicine in the treatment of AP of CHD, which can be widely used in the clinic.

A systematic review and meta-analysis of clinical research on treating angina pectoris of coronary heart disease with traditional Chinese medicine to promote blood circulation and remove blood stasis.

Research has shown that traditional Chinese medicine (TCM) can achieve good results in the treatment of angina pectoris. In this study, we aimed to explore the therapeutic effect of TCM in the treatment of angina pectoris of coronary heart disease (CHD) through a literature search and meta-analysis. The PubMed, Embase, CBM (China Biology Medicine) Web of Science databases were searched for studies on the treatment of angina pectoris of CHD with TCM. Inclusion and exclusion criteria were applied, and high-quality articles published from 2010.1 to 2021.8 were selected. The RevMan 5.3.5 software was used to evaluate the therapeutic effect indicators of TCM. Nine studies involving 824 patients were included in the meta-analysis, and the overall risk of literature bias was low. The results of meta-analysis showed that compared with conventional Western medicine, TCM + conventional Western medicine had a better efficacy indicators of angina pectoris using the fixed-effects model [odd rate (OR) =3.20, 95% confidence interval (CI): (2.09, 4.90), Z=5.35, P<0.00001]. The frequency of angina pectoris was measured by random-effects model, and the statistical results were [standard mean difference (SMD) =-1.85, 95% CI: (-2.29, -1.41), Z=8.22, P<0.00001]. The adverse events was measured by fixed-effects model, and the statistical results were [OR =0.48, 95% CI: (0.21, 1.08), Z=1.78, P=0.08]. The application of TCM in the treatment of angina pectoris of CHD can improve the therapeutic effect, reduce the frequency of angina pectoris, shorten the attack time, reduce serum total cholesterol, and improve the quality of life after treatment, but it has no obvious reducing effect on blood lipids.