Assessment of Acute Episodes in Chronic Stable Angina: A Clinical-Laboratory Approach to the Use of the Coronary Vasodilator Propatyl Nitrate

Background/Objectives: Propatyl nitrate is a coronary vasodilator with immediate and prolonged action, indicated in the treatment and prevention of acute angina pectoris episodes. Methods: This was an open, self-paired comparative study performed at UNIFESO Medical School evaluating the clinical and laboratory results of treatment with propatyl nitrate in patients with chronic stable angina pectoris. Subjects received 10 mg of propatyl nitrate, at the dose of three sublingual tablets per day, to be taken at 8:00 A.M., 2:00 P.M., and 8:00 P.M. Subjects returned to the study center after 15 days of treatment for Visit 2 assessments, and at the end of the 30-day treatment period (Visit 3). Results: A total of 200 subjects were included in the study. There was a statistically significant reduction in blood pressure (p < 0.0001) and heart rate (p = 0.0001), but no change in respiratory rate (p = 0.23). Laboratory results did not vary throughout the treatment period. There was no significant change from pretreatment in the SAQ Physical Limitation scale (p = 0.7415). The Angina Stability, Angina Frequency, and Treatment Satisfaction, and Quality of Life scales showed a significant improvement from pretreatment (p < 0.0001). Adverse events were observed among 41 subjects at Visit 2 and 35 subjects at Visit 3. Conclusions: Propatyl nitrate was safe and effective in treating chronic stable angina pectoris over the course of the 30-day treatment period. Treatment with propatyl nitrate increased angina stability and reduced angina frequency while increasing treatment satisfaction and quality of life in the patient population evaluated.

Effectiveness of Shenshu Guanxin recipe granules(参术冠心方颗粒)for improving exercise tolerance in patients with stable angina pectoris:a randomized,double-blind,placebo-controlled trial

OBJECTIVE:To assess the effectivess of Shenshu Guanxin recipe granules(参术冠心方颗粒,SGR)in improving exercise tolerance and the quality of life in patients with Stable Angina Pectoris(SAP).METHODS:A total of 189 patients were consecutively enrolled between December 2012 and December 2014.The included patients were randomly assigned to SGR and placebo groups.The primary endpoints included mainly the results of treadmill exercise test and Seattle Angina Questionnaire(SAQ)during 12 weeks of treatment.RESULTS:After 12 weeks of treatment,SGR extended the time of exercise-induced ST-segment depression of 0.1 MV,lowered the maximum ST-segment depression,and shortened the duration of ST-segment depression in patients with SAP in southern China.Besides,the study also proved that SGR could improve the quality of life and functional status of patients with SAP.CONCLUSIONS:SGR showed a positive effect on exercise tolerance compared with the placebo besides optimal medical therapy.Also,the study proved that SGR could improve the SAQ score of the patients.

Effect of Shenshao Tablet(参芍片) on the Quality of Life for Coronary Heart Disease Patients with Stable Angina Pectoris

Objective： To observe the effect of Chinese medicine Shenshao Tablet （参芍片, SST） on the quality of life in coronary heart disease （CHD） patients with stable angina pectoris （SAP）. Methods： Sixty-six patients with SAP confirmed by coronary angiography were enrolled and assigned to two groups by means of PROC PLAN using a SAS 6.12 software in a double-blinded, randomized, placebo-controlled design. Patients in the treated group were treated with SST, and the others in the control group were given placebo. The weekly angina frequency, quality of life scale [Seattle Angina Questionnaire （SAQ）] and incidence of important clinical events were observed to evaluate the intervention effect of SST on the quality of life for CHD patients with SAP. Results： During the study, one case dropped out in the treated group and two cases in the control group, respectively, and 63 cases including 32 cases in the treated group, and 31 cases in the control group completed the trial. After four weeks of treatment, the weekly angina frequency of the treated group （5.32± 2.46 times per week） was significantly less than that of the control group （7.32± 3.20 times per week, P 〈 0.05）. The total score of the quality of life in the treated group （71.30± 5.44） was obviously higher than that in the control group （63.50± 4.60, P 〈 0.01）, and the angina stability, angina frequency, and treatment satisfaction were significantly superior to those in the control group （P〈 0.01）. The incidence of important clinical events of the treated group （3.1%） was lower than that of the control group （6.5%） during the six-month follow-up period, but the difference was insignificant （P 〉 0.05）. Conclusion： SST could lower the angina frequency and greatly improve the quality of life in CHD patients with SAP.

Effect of Yiqi Yangyin Decoction(益气养阴方) on the Quality of Life of Patients with Unstable Angina Pectoris

Objective： To observe the effect of Yiqi Yangyin Decoction （益气养阴方, YQYYD） on the quality of life （QOL） of patients with unstable angina pectoris （UAP）. Methods： A total of 108 patients with UAP of qi-yin deficiency syndrome confirmed by coronary angiography were enrolled and assigned to the treated group （treated with YQYYD and conventional therapy of Western medicine） and the control group （treated with conventional therapy of Western medicine）, by the use of the PROC PLAN of the SAS 6.12 software, in a prospective, randomized, controlled design. The clinical total effective rate, symptom score, QOL scale [Seattle Angina Questionnaire （SAQ）] and incidence of important clinical events were defined as the observation indices to evaluate the interventional effect of YQYYD on the QOL of patients with UAP of the qi-yin deficiency syndrome. Results： During the study, three cases dropped out in the treated group, one case dropped out in the control group, and 104 cases, including 51 cases in the treatment group and 53 cases in the control group, finished the trial. After four weeks of treatment, the total clinical effective rates in the treated group and the control group were 80.4% and 75.5% respectively, and there was no obvious difference between them （P〉0.05）. However, the symptom score of the treated group （9.31 ± 2.02） was significantly lesser than that of the control group （11.62 ± 3.04, P〈0.05）, and the total score of the QOI scale of the treated group （68.76 ± 5.74） was significantly higher than that of the control group （61.06 ±3.31, P〈0.01）. Among those in the treated group physical limitation, angina stability, angina frequency, and treatment satisfaction were significantly ameliorated when compared with the control group after treatment （P〈0.05, P〈0.01）. The incidence of important clinical events in the treated group （3.9%） was lower than that in the control group （5.7%） during the 8-month follow-up period, but the difference was insignificant （P〉0.05）. Conclusion： YQYYD could improve the clinical symptoms of patients with UAP of qi-yin deficiency syndrome and greatly improve their QOL.

Effect of Liandouqingmai recipe on quality of life and inflammatory reactions of patients with coronary heart disease

OBJECTIVE: To observe the effect of Liandouqingmai recipe(Chinese herbal medicine compound preparation) on the quality of life(QOL) and inflammatory reaction of patients with coronary heart disease(CHD).METHODS: A total of 101 CHD patients were randomized into two groups: treatment group(n=45)receiving standard treatment for CHD plus Liandouqingmai recipe, and control group(n=56) receiving standard treatment only. The control group contained 16 normal healthy subjects. Changes in hs-C-reactive protein(CRP), peripheral blood leucocytes(PBL), and interleukin(IL)-6 and IL-10 levels were measured. The Seattle Angina Questionnaire(SAQ) was used to determine patient QOL before and after treatment for 2 weeks.RESULTS: Before treatment, SAQ scores [physical limitation(PL), angina stability(AS), angina frequen-cy(AF), treatment satisfaction(TS), and disease perception(DP)] were not statistically different between groups. After treatment, AS and DP levels of controls were significantly increased compared with the other groups, while PL, AS, AF, TS, and DP levels of the treatment group were significantly increased compared with controls. Treatment group SAQ scores(PL, AS, AF, TS, and DP) were significantly higher than for controls. CHD patient IL-6 and IL-10 levels were significantly higher than controls.Before treatment, mean levels of IL-6, hs-CRP and PBL of the two groups were not statistically different. After treatment, mean levels of IL-6, IL-10,hs-CRP and PBL of the two groups were significantly decreased compared with their before treatment values, and levels of IL-6, hs-CRP, and PBL of the treatment group were lower than controls. Although mean IL-10 levels of both groups decreased, there was no significant difference in between-group and in-group comparisons before and after treatment. Mean levels of IL-6 and IL-10 in the normal group were lower than in CHD patients.SAQ scores of QOL were negatively associated with the inflammatory index(IL-6/IL-10), and there was a significant negative association of IL-10 with AS(r=﹣0.15, P<0.05).CONCLUSION: Inflammatory reactions in CHD patients are related to angina status. Coadministration of CHD standard treatment and Liandouqingmai recipe increased patient SAQ scores by decreasing IL-6, IL-10, hs-CRP, and PBL levels in CHD patients, which might inhibit endothelial inflammation to improve patient QOL.