摘要
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 at 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.
目的:本研究旨在探讨中成药(CPM)在降低冠心病(CHD)心绞痛患者主要不良心血管事件(MACE)发生率和提高临床疗效方面的作用,为其临床辅助治疗提供依据。方法:将6家医院28517例冠心病心绞痛住院患者分为CPM组(n=11374)和非CPM组(n=17143),评估MACE的发生率,包括心肌梗死、经皮冠状动脉介入治疗、冠状动脉搭桥术。结果:CPM组MACE发生率低于非CPM组。CPM治疗是降低MACE总体风险的独立保护因素[HR=0.40,95%CI(0.33;0.49)]。CPM组中接受一种、两种或三种CPM的患者可以从CPM的辅助治疗中受益,并且服用更多类型的CPM与较低的MACE风险相关。此外,男性人群服用CPM优于女性,55-64岁的中年人更适合在西药基础上服用CPM。结论:CPM作为辅助治疗可降低冠心病心绞痛患者尤其是男性和中年人群MACE的发生,应优化相应药物治疗方案。然而,这一结论未来还需通过前瞻性队列研究进一步验证。
基金
supported by the National Basic Research Program of China(973 project,grant number:2014CB542902)
Tianjin Hongrentang Pharmaceutical Co.,Ltd.,Tianjin,China(grant number:HX202016)。
