BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a ...BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a traditional Chinese medicine,improves cardiovascular symptoms,while nicorandil alleviates spasms and angina.Both have potential in treating CAD.AIM To investigate the therapeutic effects of combining Pericarpium Trichosanthis injection and nicorandil in elderly patients suffering from refractory angina caused by coronary heart disease.METHODS A retrospective analysis was conducted on the data of 130 patients diagnosed with refractory coronary heart disease.Based on the different treatment regimens administered during hospitalization,the patients were divided into a control group(58 cases)and a study group(72 cases).The control group received conven-tional treatment,which included aspirin,statins,and nitrate vasodilators.In addition to the conventional medication,the study group received a combination treatment of Pericarpium Trichosanthis injection and nicorandil.RESULTS After treatment,the study group showed significantly higher left ventricular ejection fraction and cardiac output,and lower brain natriuretic peptide and C-reactive protein levels compared to the control group.The study group also exhibited improvements in angina,quality of life,exercise endurance,and lipid profiles.Multivariate logistic regression analysis revealed a relationship of lipid levels and heart function with the combined treatment.Some patients in the study group experienced headaches during treatment,but no significant adverse reactions were observed.Follow-up showed that the treatment was well-tolerated,with no drug-related adverse reactions detected.CONCLUSION Combination of Pericarpium Trichosanthis injection and nicorandil is more effective than conventional treatment in improving symptoms and heart function in elderly patients with refractory angina pectoris.展开更多
The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis ...The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis is obstruction of the heart collaterals,and treatment mainly adopts dredging collaterals and relieving pain.Based on the treatment principles of dredging collaterals with pungent,aiming at the etiology,pathogenesis and disease characteristics of angina pectoris in coronary heart disease,this article systematically analyzes the Method of Dredging Collaterals with Pungent including the methods of dredging collaterals with pungent moisture,dredging collaterals with pungent warm,dredging collaterals with pungent aroma,and dredging collaterals with insect type drugs,to provide ideas for the treatment of angina pectoris in coronary heart disease.展开更多
Background:Dengzhanxixin Injection(DZXXI)has been widely used to treat Coronary heart disease with angina pectoris patients.Therefore,the study aimed to evaluate the therapeutic efficacy and safety of DZXXI in treatin...Background:Dengzhanxixin Injection(DZXXI)has been widely used to treat Coronary heart disease with angina pectoris patients.Therefore,the study aimed to evaluate the therapeutic efficacy and safety of DZXXI in treating Coronary heart disease with angina pectoris.Methods:The Cochrane Library,the China National Knowledge Infrastructure database,the Wanfang database,the VIP database,the PubMed database,the Medline database,the EMBASE database,and Clinical Trial were used to search literatures up to August 2022.Results:The results showed that DZXXI combined with conventional therapy were significant in clinical efficacy(relative risk(RR)=1.23,95%cerebral infarction(CI):1.18,1.29;P<0.01)and electrocardiogram curative effect(RR=1.35,95%CI:1.24-1.47;P<0.01),even the subgroup of the DZXXI≤20 ml showed the largest difference.In addition,DZXXI combined with conventional therapy could lower the level of triacylglycerol(mean difference(MD)=−0.63,95%CI:−0.72,−0.55;P<0.01),total cholesterol(MD=−1.18,95%CI:−1.28,−1.09;P<0.01)and low density lipoprotein-cholesterol(MD=−0.98,95%CI:−1.08,−0.88;P<0.01),improve the level of high density lipoprotein-cholesterol(MD=0.41,95%CI:0.33,0.49;P<0.01),blood viscosity(MD=−1.09,95%CI:−1.32,−1.86,P<0.01),plasma viscosity(MD=−0.11,95%CI:−0.11,−0.11,P<0.01)and fibrin(MD=−1.50,95%CI:−1.53,−1.47,P<0.01).Conclusion:These findings revealed that there was more efficacious in DZXXI combined with conventional therapy than that in conventional therapy for the Coronary heart disease with angina pectoris and low dose of DZXXI might be suggested.展开更多
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 an...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.展开更多
With the catgut-embedding therapy, the author treated 46 cases of angina pectoris from October 1997 to February 2002, and achieved good therapeutic results. This is reported as follows.
Objective:To evaluate the efficacy of Ginseng combined with conventional therapy for stable angina pectoris(SAP).Methods:From the Cochrane Library,Pubmed,Embase,Web of Science,CNKI(China National Knowledge Infrastruct...Objective:To evaluate the efficacy of Ginseng combined with conventional therapy for stable angina pectoris(SAP).Methods:From the Cochrane Library,Pubmed,Embase,Web of Science,CNKI(China National Knowledge Infrastructure),Wanfang Datebase,VIP(Chinese Scientific Journals Database),CBM(Chinese Biomedicine Database),we reviewed the clinical randomized controlled trial(RCT),after screening and assessing the risk of bias,used RevMan 5.3 and Stata 15.0 software to make the Meta-analysis.Results:Thirteen studies were included with 1176 cases,involving 606 cases in the experimental group and 570 in the control group.The results of Meta-analysis showed that Ginseng combined with conventional therapy significantly has obvious effect on clinical effective rate(RR=1.29,95%CI[1.21,1.36],P<0.00001);ECG effective rate(RR=1.35,95%CI[1.22,1.50],P<0.00001);number of angina attacks(MD=-1.77,95%CI[-2.64,-0.91],P<0.00001);duration of angina pectoris(MD=-2.16,95%CI[-2.54,-1.78],P<0.00001);nitroglycerin dosage(MD=-1.52,95%CI[-1.81,-1.23],P<0.00001),and it is better than using conventional therapy alone.Conclusion:Ginseng combined with conventional therapy for SAP can significantly improve clinical effective rate and ECG effective rate,reduce the number of angina attacks,shorten the duration of angina pectoris,and reduce nitroglycerin dosage.The development of ginseng-related proprietary Chinese medicines has good prospects.But due to the quality of studies is medium and low,it still needs to be confirmed by conducting high-quality RCTs.展开更多
Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectori...Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.展开更多
Objectives To analyze the changes of vasoactive substances originated from endo- theiium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mech- anisms of the drug to t...Objectives To analyze the changes of vasoactive substances originated from endo- theiium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mech- anisms of the drug to treat unstable angina pectoris. Methods 120 patients with unstable angina pectoris who were not well responsed to common medication were studied. Their ECG stress tests were abnormal and there were ischemic changes in Holter. Urokinase 300,000 U was added in 100 ml normal saline and in- jected within 30 min once a day for 3 days. 300 mg as- pirin was administrated a day before and during uroki- nase applications. Before and after urokinase treat- ments , endothelin-1 , plasma tissue plasminogen activa- tor and its inhibitor-lwere determined. Results Compared with pretreatments, after treatments, the ac- tivities of tissue plasminogen activator increased, endo- thelin-1 and the inhibitor-1 decreased. The changes were significant. Conclusions Modified thrombolytic therapy can regulate the vasoactive substances origina- ted endotheiium in patients with unstable angina pecto- ris . The major substances include endothelin-1, plasma tissue plasminogen activator and inhibitor-1. This mechanism may suggest that urokinase can treat coro- nary heart disease effectively.展开更多
Objective:To investigate the effect of adjuvant salvianolate therapy on plaque stability, cell apoptosis and coagulation indexes in patients with unstable angina pectoris.Methods: 92 patients with unstable angina pect...Objective:To investigate the effect of adjuvant salvianolate therapy on plaque stability, cell apoptosis and coagulation indexes in patients with unstable angina pectoris.Methods: 92 patients with unstable angina pectoris treated in our hospital between May 2011 and August 2015 were collected, and after the treatment process and auxiliary examination results were retrospectively analyzed, they were divided into the control group (n=45) who accepted conventional treatment and the observation group (n=47) who accepted adjuvant salvianolate treatment. Before and after treatment, diasonograph was used to evaluate the plaque stability parameters of two groups of patients;ELISA was used to detect apoptosis-related molecule levels;immunoturbidimetry was used to detect blood coagulation indexes.Results: Before treatment, differences in plaque stability parameters, cell apoptosis molecules and coagulation indexes were not statistically significant between two groups of patients (P>0.05). After treatment, the plaque stability parameters plaque thickness, enhanced intensity, rise time and time to peak of observation group were significantly lower than those of control group (P<0.05);serum sFas, sFasL, fibrinogen (Fib), platelet (PLT), and D-Dimer (D-D) levels of observation group were significantly lower than those of control group while Bcl-2, prothrombin time (PT) and activated partial thromboplastin time (APTT) levels were significantly higher than those of control group (P<0.05).Conclusions: Adjuvant salvianolate treatment can increase the plaque stability, also inhibit myocardial cell apoptosis and improve the coagulation function in patients with unstable angina pectoris.展开更多
Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (OHD-AP) with Xin-blood stagnation syndrome (XBSS). Methods: Adopted...Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (OHD-AP) with Xin-blood stagnation syndrome (XBSS). Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and 112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine (TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02 % (294/323) respectively; those in improvement of TOM symptoms were 40. 18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P〈0.01). Conclusion: SYI Injection is effective and safe in treating OHD-AP-XBSS.展开更多
Objective: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods: Sixty-five patients, with coronary artery disease, were enrolle...Objective: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods: Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups: acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum of creatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum of troponin) were measured by standard laboratory methods. Results: The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and I. 12 folds in SAP patients than in the healthy controls (P〈0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml] and SAP [(3.45±0.56) ng/ml] groups (P〈0.01); WBC, hsCRP, CK CK-MBmax and cTnlmax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427,p=0.037), CK CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P〈0.01). Conclusion: Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.展开更多
Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in pa...Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular (CV) events, including hospital readmission for angina pectoris, acute myocardial infarction (AMI), congestive heart failure (CHF), stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred (84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality). In a multivariate Cox model, LAAI [OR: 1.140, 95% CI: 1.01±1.279, P = 0.026], diastolic blood pressure (OR: 0.976, 95% CI: 0.956-0.996, P = 0.020) and pulse pressure (OR 1.020, 95% CI: 1.007-1.034, P = 0.004) were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.展开更多
Objective: To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection (SSLA) in treating coronary heart diseases angina pectoris (CHD-AP) of Xin-blood stasis syn...Objective: To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection (SSLA) in treating coronary heart diseases angina pectoris (CHD-AP) of Xin-blood stasis syndrome type, and to conduct the non-inferiority trial with Danshen injection (丹参注射液, DSI) as positive control. Methods: An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ , Ⅱand Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results: The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility (P〈0.01). Adverse reaction appeared in 8 patients in the test groups and 2 in the control group. Conclusion: SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSI, and no evident toxic-adverse reaction.展开更多
Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosor...Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay(ELISA), serum VEGF concentrations were determined in antecubital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarction(AMI) before and after thrombolytic therapy, and of 16 age- and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(9860±2699pg/ml) and UAP (10361±2489pg/ml) tended to be higher than those in control subjects(8044±2457pg/ml), but the differences did not reach statistical significance (P>005 for each). Before thrombolytic therapy, the concentrations of serum VEGF in patients with AMI (28592±12515pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects (P<001,respectively), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents(r=0866,P<0001 and r=0948,P<0001;respectively). Three hours after thrombolysis, the concentrations of VEGF had fallen to 11157±3129pg/ml (P<001 vs. before thrombolytic therapy and P<005 vs.control subjects). Conclusion. The present study shows that serum concentrations of VEGF in patients with AMI are markedly elevated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfusion.展开更多
TCM holds that angina pectoris is apathogenic state induced by stagnant heart-qi,stagnancy of qi and blood, or obstruction ofthe heart orifice due to blood stasis or turbidphlegm. Based on TCM differentiation,
Objective:This study aimed to develop a core outcome set(COS)for use in future studies of stable angina pectoris(SAP)in traditional Chinese medicine(TCM).Methods:Systematic literature reviews and qualitative interview...Objective:This study aimed to develop a core outcome set(COS)for use in future studies of stable angina pectoris(SAP)in traditional Chinese medicine(TCM).Methods:Systematic literature reviews and qualitative interviews with cardiologists and patients with SAP treated using TCM were conducted to generate a set of outcomes.Outcomes were prioritized by stakeholders via two rounds of an online Delphi survey and face-to-face consensus meetings.Following the final consensus meeting,a final COS was generated.Results:An initial set of 324 outcomes was identified.A preliminary list of 65 outcomes was employed in the Delphi study.In total,223 participants from seven stakeholder groups were invited to score outcomes in the first Delphi round:87 completed round 1 and 47 completed round 2.Thirty-one participants attended the consensus meeting and agreed on a final core set of outcomes comprising six items across four domains:frequency of angina attack,duration of angina attack,Seattle angina questionnaire,total exercise duration in the exercise treadmill test,cardiovascular events,and QT interval on electrocardiography.Conclusions:The COS developed in this study provides the minimum requirements for measurement and reporting in future TCM clinical trials for the treatment of SAP.The employment of this COS may reduce heterogeneity across trials and facilitate evidencebased decision-making for stakeholders.展开更多
Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chin...Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.展开更多
Background: Misdiagnosis of angina pectoris is not uncommon in athletes. Physicians can fail to make a correct clinical diagnosis if they don’t have the skills and experience needed to recognize this disease. Case Re...Background: Misdiagnosis of angina pectoris is not uncommon in athletes. Physicians can fail to make a correct clinical diagnosis if they don’t have the skills and experience needed to recognize this disease. Case Report: This case report describes an exertional angina misdiagnosis due to a severe coronary artery disease in a 50-year-old male athlete initially examined by both a general practitioner and a cardiologist. The athlete subsequently underwent physical examination in a sports cardiology medicine center where diagnosis of angina pectoris caused by severe mono-vessel coronary artery disease was made, requiring an angioplasty with stenting. Conclusions: Although most of the severe symptoms in a heart attack are hard to miss, sometimes in athletes angina pectoris is not readily recognized. However, this is dangerous and can lead to the sudden death of the athlete. Diagnosis must be timely and accurate, in order for the patient to receive the best prognosis.展开更多
Background: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in Iranian population. The aim of this study was the investigation of association between nonalcoholic fatty liver disease (NAFLD) and c...Background: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in Iranian population. The aim of this study was the investigation of association between nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) in patients with angina pectoris. Methods: 82 patients with confirmed CAD by coronary angiography and 82 individuals with normal coronary angiography, as the control group, were selected. Hepatic ultrasound scanning was performed in all the subjects to determinate the NAFLD. Data were analyzed by SPSS software and independent T-test and Chi-square tests. Results: Findings gathered from the patients with angina pectoris showed that the prevalence of NAFLD in CAD patients was higher than the control group. Grade of fatty liver and the portal vein size in CAD patients were significantly more than the control group. Conclusion: NAFLD is a risk factor of CAD in the angina pectoris patients. Increase in the prevalence of NAFLD can lead to the increase in cardiovascular diseases.展开更多
文摘BACKGROUND Coronary artery disease(CAD)is a leading cause of global cardiovascular morta-lity.Refractory angina pectoris,a manifestation of CAD,requires effective drug treatments.Pericarpium Trichosanthis injection,a traditional Chinese medicine,improves cardiovascular symptoms,while nicorandil alleviates spasms and angina.Both have potential in treating CAD.AIM To investigate the therapeutic effects of combining Pericarpium Trichosanthis injection and nicorandil in elderly patients suffering from refractory angina caused by coronary heart disease.METHODS A retrospective analysis was conducted on the data of 130 patients diagnosed with refractory coronary heart disease.Based on the different treatment regimens administered during hospitalization,the patients were divided into a control group(58 cases)and a study group(72 cases).The control group received conven-tional treatment,which included aspirin,statins,and nitrate vasodilators.In addition to the conventional medication,the study group received a combination treatment of Pericarpium Trichosanthis injection and nicorandil.RESULTS After treatment,the study group showed significantly higher left ventricular ejection fraction and cardiac output,and lower brain natriuretic peptide and C-reactive protein levels compared to the control group.The study group also exhibited improvements in angina,quality of life,exercise endurance,and lipid profiles.Multivariate logistic regression analysis revealed a relationship of lipid levels and heart function with the combined treatment.Some patients in the study group experienced headaches during treatment,but no significant adverse reactions were observed.Follow-up showed that the treatment was well-tolerated,with no drug-related adverse reactions detected.CONCLUSION Combination of Pericarpium Trichosanthis injection and nicorandil is more effective than conventional treatment in improving symptoms and heart function in elderly patients with refractory angina pectoris.
基金Supported by the Youth Science Fund Project of the National Natural Science Foundation of China(30304117474)Scientific Research Project of Shanghai Municipal Health Commission(202040308)。
文摘The angina pectoris in coronary heart disease belongs to the category of"chest impediment"in traditional Chinese medicine,and belongs to the syndrome of root deficiency with tip excess.Its main pathogenesis is obstruction of the heart collaterals,and treatment mainly adopts dredging collaterals and relieving pain.Based on the treatment principles of dredging collaterals with pungent,aiming at the etiology,pathogenesis and disease characteristics of angina pectoris in coronary heart disease,this article systematically analyzes the Method of Dredging Collaterals with Pungent including the methods of dredging collaterals with pungent moisture,dredging collaterals with pungent warm,dredging collaterals with pungent aroma,and dredging collaterals with insect type drugs,to provide ideas for the treatment of angina pectoris in coronary heart disease.
基金supported by Wuxi Municipal Health Commission(M202027)Wuxi Science and Technology Bureau(N20202022).
文摘Background:Dengzhanxixin Injection(DZXXI)has been widely used to treat Coronary heart disease with angina pectoris patients.Therefore,the study aimed to evaluate the therapeutic efficacy and safety of DZXXI in treating Coronary heart disease with angina pectoris.Methods:The Cochrane Library,the China National Knowledge Infrastructure database,the Wanfang database,the VIP database,the PubMed database,the Medline database,the EMBASE database,and Clinical Trial were used to search literatures up to August 2022.Results:The results showed that DZXXI combined with conventional therapy were significant in clinical efficacy(relative risk(RR)=1.23,95%cerebral infarction(CI):1.18,1.29;P<0.01)and electrocardiogram curative effect(RR=1.35,95%CI:1.24-1.47;P<0.01),even the subgroup of the DZXXI≤20 ml showed the largest difference.In addition,DZXXI combined with conventional therapy could lower the level of triacylglycerol(mean difference(MD)=−0.63,95%CI:−0.72,−0.55;P<0.01),total cholesterol(MD=−1.18,95%CI:−1.28,−1.09;P<0.01)and low density lipoprotein-cholesterol(MD=−0.98,95%CI:−1.08,−0.88;P<0.01),improve the level of high density lipoprotein-cholesterol(MD=0.41,95%CI:0.33,0.49;P<0.01),blood viscosity(MD=−1.09,95%CI:−1.32,−1.86,P<0.01),plasma viscosity(MD=−0.11,95%CI:−0.11,−0.11,P<0.01)and fibrin(MD=−1.50,95%CI:−1.53,−1.47,P<0.01).Conclusion:These findings revealed that there was more efficacious in DZXXI combined with conventional therapy than that in conventional therapy for the Coronary heart disease with angina pectoris and low dose of DZXXI might be suggested.
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)。
文摘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.
文摘With the catgut-embedding therapy, the author treated 46 cases of angina pectoris from October 1997 to February 2002, and achieved good therapeutic results. This is reported as follows.
基金National Science and Technology Major Special Project and New Drug Creation Project(No.2017ZX09301003)
文摘Objective:To evaluate the efficacy of Ginseng combined with conventional therapy for stable angina pectoris(SAP).Methods:From the Cochrane Library,Pubmed,Embase,Web of Science,CNKI(China National Knowledge Infrastructure),Wanfang Datebase,VIP(Chinese Scientific Journals Database),CBM(Chinese Biomedicine Database),we reviewed the clinical randomized controlled trial(RCT),after screening and assessing the risk of bias,used RevMan 5.3 and Stata 15.0 software to make the Meta-analysis.Results:Thirteen studies were included with 1176 cases,involving 606 cases in the experimental group and 570 in the control group.The results of Meta-analysis showed that Ginseng combined with conventional therapy significantly has obvious effect on clinical effective rate(RR=1.29,95%CI[1.21,1.36],P<0.00001);ECG effective rate(RR=1.35,95%CI[1.22,1.50],P<0.00001);number of angina attacks(MD=-1.77,95%CI[-2.64,-0.91],P<0.00001);duration of angina pectoris(MD=-2.16,95%CI[-2.54,-1.78],P<0.00001);nitroglycerin dosage(MD=-1.52,95%CI[-1.81,-1.23],P<0.00001),and it is better than using conventional therapy alone.Conclusion:Ginseng combined with conventional therapy for SAP can significantly improve clinical effective rate and ECG effective rate,reduce the number of angina attacks,shorten the duration of angina pectoris,and reduce nitroglycerin dosage.The development of ginseng-related proprietary Chinese medicines has good prospects.But due to the quality of studies is medium and low,it still needs to be confirmed by conducting high-quality RCTs.
文摘Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.
文摘Objectives To analyze the changes of vasoactive substances originated from endo- theiium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mech- anisms of the drug to treat unstable angina pectoris. Methods 120 patients with unstable angina pectoris who were not well responsed to common medication were studied. Their ECG stress tests were abnormal and there were ischemic changes in Holter. Urokinase 300,000 U was added in 100 ml normal saline and in- jected within 30 min once a day for 3 days. 300 mg as- pirin was administrated a day before and during uroki- nase applications. Before and after urokinase treat- ments , endothelin-1 , plasma tissue plasminogen activa- tor and its inhibitor-lwere determined. Results Compared with pretreatments, after treatments, the ac- tivities of tissue plasminogen activator increased, endo- thelin-1 and the inhibitor-1 decreased. The changes were significant. Conclusions Modified thrombolytic therapy can regulate the vasoactive substances origina- ted endotheiium in patients with unstable angina pecto- ris . The major substances include endothelin-1, plasma tissue plasminogen activator and inhibitor-1. This mechanism may suggest that urokinase can treat coro- nary heart disease effectively.
文摘Objective:To investigate the effect of adjuvant salvianolate therapy on plaque stability, cell apoptosis and coagulation indexes in patients with unstable angina pectoris.Methods: 92 patients with unstable angina pectoris treated in our hospital between May 2011 and August 2015 were collected, and after the treatment process and auxiliary examination results were retrospectively analyzed, they were divided into the control group (n=45) who accepted conventional treatment and the observation group (n=47) who accepted adjuvant salvianolate treatment. Before and after treatment, diasonograph was used to evaluate the plaque stability parameters of two groups of patients;ELISA was used to detect apoptosis-related molecule levels;immunoturbidimetry was used to detect blood coagulation indexes.Results: Before treatment, differences in plaque stability parameters, cell apoptosis molecules and coagulation indexes were not statistically significant between two groups of patients (P>0.05). After treatment, the plaque stability parameters plaque thickness, enhanced intensity, rise time and time to peak of observation group were significantly lower than those of control group (P<0.05);serum sFas, sFasL, fibrinogen (Fib), platelet (PLT), and D-Dimer (D-D) levels of observation group were significantly lower than those of control group while Bcl-2, prothrombin time (PT) and activated partial thromboplastin time (APTT) levels were significantly higher than those of control group (P<0.05).Conclusions: Adjuvant salvianolate treatment can increase the plaque stability, also inhibit myocardial cell apoptosis and improve the coagulation function in patients with unstable angina pectoris.
文摘Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (OHD-AP) with Xin-blood stagnation syndrome (XBSS). Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and 112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine (TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02 % (294/323) respectively; those in improvement of TOM symptoms were 40. 18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P〈0.01). Conclusion: SYI Injection is effective and safe in treating OHD-AP-XBSS.
基金Project (No. 2003C33031) supported by the Science and Technology Department of Zhejiang Province, China
文摘Objective: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods: Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups: acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum of creatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum of troponin) were measured by standard laboratory methods. Results: The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and I. 12 folds in SAP patients than in the healthy controls (P〈0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml] and SAP [(3.45±0.56) ng/ml] groups (P〈0.01); WBC, hsCRP, CK CK-MBmax and cTnlmax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427,p=0.037), CK CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P〈0.01). Conclusion: Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.
文摘Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular (CV) events, including hospital readmission for angina pectoris, acute myocardial infarction (AMI), congestive heart failure (CHF), stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred (84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality). In a multivariate Cox model, LAAI [OR: 1.140, 95% CI: 1.01±1.279, P = 0.026], diastolic blood pressure (OR: 0.976, 95% CI: 0.956-0.996, P = 0.020) and pulse pressure (OR 1.020, 95% CI: 1.007-1.034, P = 0.004) were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.
基金Supported by the Fund of National Project of High.technicResearch and Development,(No.2003AA223269)
文摘Objective: To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection (SSLA) in treating coronary heart diseases angina pectoris (CHD-AP) of Xin-blood stasis syndrome type, and to conduct the non-inferiority trial with Danshen injection (丹参注射液, DSI) as positive control. Methods: An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ , Ⅱand Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results: The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility (P〈0.01). Adverse reaction appeared in 8 patients in the test groups and 2 in the control group. Conclusion: SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSI, and no evident toxic-adverse reaction.
基金ThisstudywassupportedinpartbythemedicalresearchgrantsofGuangdongProvince (No :A19990 48)
文摘Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay(ELISA), serum VEGF concentrations were determined in antecubital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarction(AMI) before and after thrombolytic therapy, and of 16 age- and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(9860±2699pg/ml) and UAP (10361±2489pg/ml) tended to be higher than those in control subjects(8044±2457pg/ml), but the differences did not reach statistical significance (P>005 for each). Before thrombolytic therapy, the concentrations of serum VEGF in patients with AMI (28592±12515pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects (P<001,respectively), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents(r=0866,P<0001 and r=0948,P<0001;respectively). Three hours after thrombolysis, the concentrations of VEGF had fallen to 11157±3129pg/ml (P<001 vs. before thrombolytic therapy and P<005 vs.control subjects). Conclusion. The present study shows that serum concentrations of VEGF in patients with AMI are markedly elevated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfusion.
文摘TCM holds that angina pectoris is apathogenic state induced by stagnant heart-qi,stagnancy of qi and blood, or obstruction ofthe heart orifice due to blood stasis or turbidphlegm. Based on TCM differentiation,
基金supported by the National Natural Science Foundation of China(No.81473544).
文摘Objective:This study aimed to develop a core outcome set(COS)for use in future studies of stable angina pectoris(SAP)in traditional Chinese medicine(TCM).Methods:Systematic literature reviews and qualitative interviews with cardiologists and patients with SAP treated using TCM were conducted to generate a set of outcomes.Outcomes were prioritized by stakeholders via two rounds of an online Delphi survey and face-to-face consensus meetings.Following the final consensus meeting,a final COS was generated.Results:An initial set of 324 outcomes was identified.A preliminary list of 65 outcomes was employed in the Delphi study.In total,223 participants from seven stakeholder groups were invited to score outcomes in the first Delphi round:87 completed round 1 and 47 completed round 2.Thirty-one participants attended the consensus meeting and agreed on a final core set of outcomes comprising six items across four domains:frequency of angina attack,duration of angina attack,Seattle angina questionnaire,total exercise duration in the exercise treadmill test,cardiovascular events,and QT interval on electrocardiography.Conclusions:The COS developed in this study provides the minimum requirements for measurement and reporting in future TCM clinical trials for the treatment of SAP.The employment of this COS may reduce heterogeneity across trials and facilitate evidencebased decision-making for stakeholders.
基金National Key research and Deve lopment Progr am(No.2018YFC1707410)。
文摘Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.
文摘Background: Misdiagnosis of angina pectoris is not uncommon in athletes. Physicians can fail to make a correct clinical diagnosis if they don’t have the skills and experience needed to recognize this disease. Case Report: This case report describes an exertional angina misdiagnosis due to a severe coronary artery disease in a 50-year-old male athlete initially examined by both a general practitioner and a cardiologist. The athlete subsequently underwent physical examination in a sports cardiology medicine center where diagnosis of angina pectoris caused by severe mono-vessel coronary artery disease was made, requiring an angioplasty with stenting. Conclusions: Although most of the severe symptoms in a heart attack are hard to miss, sometimes in athletes angina pectoris is not readily recognized. However, this is dangerous and can lead to the sudden death of the athlete. Diagnosis must be timely and accurate, in order for the patient to receive the best prognosis.
文摘Background: Prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing in Iranian population. The aim of this study was the investigation of association between nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD) in patients with angina pectoris. Methods: 82 patients with confirmed CAD by coronary angiography and 82 individuals with normal coronary angiography, as the control group, were selected. Hepatic ultrasound scanning was performed in all the subjects to determinate the NAFLD. Data were analyzed by SPSS software and independent T-test and Chi-square tests. Results: Findings gathered from the patients with angina pectoris showed that the prevalence of NAFLD in CAD patients was higher than the control group. Grade of fatty liver and the portal vein size in CAD patients were significantly more than the control group. Conclusion: NAFLD is a risk factor of CAD in the angina pectoris patients. Increase in the prevalence of NAFLD can lead to the increase in cardiovascular diseases.