Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure:A Multicenter,Large Sample Capacity,Long-Term Follow-Up Retrospective Cohort Study

Objective:To explore the effect of Shenmai Injection(SMI)on the long-term prognosis of patients with chronic heart failure(CHF).Methods:The Hospital Information System was used to extract data of CHF patients,and the retrospective cohort study was conducted for analysis.In non-exposed group,standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group,SMI were applied for more than 7 days.Evaluation indicators are followed with New York Heart Association functional classification(NYHA classification),left ventricular ejection fraction(LVEF),N-terminal brain natriuretic peptide precursor(NT-ProBNP),cardiogenic death and heart failure(HF)readmission.Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events.Results:A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up successfully.After treatment,the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30%and 43.45%,respectively;the improvement values of LVEF were 8.89%and 7.91%,respectively;the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL,respectively.After exposure on SMI,the rates of cardiogenic death and HF readmission reduced from 15.43%to 10.18%and 38.93%to 32.37%.According to Kaplan-Meier analysis,the log-rank P value of SMI and cardiogenic death was 0.014,while the counterpart of SMI and HF readmission was 0.025.Cox regression analysis indicated that for cardiogenic death,age,cardiomyopathy,diabetes,and NYHA classification were risk factors whileβ-blockers,aldosterone receptor antagonists,Chinese patent medicine/decoction and SMI were protective factors.Likewise,for HF readmission,age,cardiomyopathy,and NYHA classification were risk factors while SMI was a protective factor.Conclusion:Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients,and thereby improve the long-term prognosis.