Effect of Yangxinshi Tablets on the Phenotype and Function of Monocytes in Patients with Unstable Angina Pectoris of Coronary Heart Disease

Objective:The objective of this study was to observe the effect of Yangxinshi tablets on the phenotype and function of peripheral blood monocytes in patients with unstable angina of coronary heart disease(CHD)and to explore the possible mechanism of Yangxinshi tablets in the treatment of CHD.Methods:A total of 100 patients with unstable angina of CHD were randomly divided into two groups:Group A–treatment group and Group B–control group.The phenotypic and functional changes in blood monocytes and the changes in serum inflammatory factors before and after treatment were compared in the two groups.Results:The expression of CD14^+CD163^+interleukin(IL)-10^+was significantly higher in the control group than in the patients with unstable angina of CHD,whereas the expression of CD14^+CD163-IL-12^+was lower.The concentration of IL-10 was higher in the control group than in the patients with unstable angina,whereas the concentration of tumor necrosis factor-α(TNF-α)and IL-12 was significantly lower.In Group A,the expression of CD14^+CD163^+,CD14^+CD206^+,and CD14^+CD163^+CD206^+in peripheral blood monocytes increased after treatment than before treatment,whereas the expression of CD14^+CD163-CD206-decreased.The expression of CD14^+CD163-IL-12^+decreased after treatment than before,whereas CD14^+CD163^+IL-10^+expression increased.The serum concentration of IL-10 in Group A was higher after treatment than before,whereas that of IL-12 and TNF-αwas lower.In Group B,the phenotype and function of the peripheral blood monocytes remained unchanged.Conclusion:Yangxinshi tablet therapy can change the phenotype of the peripheral blood monocytes in patients with unstable angina of CHD.Yangxinshi tablet therapy changes the inflammatory state in patients with an increase in the expression of anti-inflammatory factors and a decrease in the expression of inflammatory factors.

Yangxinshi Tablets Versus Trimetazidine on Exercise Tolerance After Percutaneous Coronary Intervention: Rationale and Design of the Double-blind, Randomized HEARTRIP Trial

Improving exercise tolerance is indisputably beneficial for long-term survival in patients treated with percutaneous coronary intervention(PCI).Although previous studies suggested that Yangxinshi tablets effectively improve exercise tolerance in patients with coronary heart disease,the evidence is limited due to the lack of high-quality randomized trials.The Effects of Yangxinshi Tablets on Exercise Tolerance Compared with Trimetazidine in Patients after PCI(HEARTRIP)trial is a multicenter,double-blind,double-dummy,active drug-controlled,randomized trial designed to test if the effects of Yangxinshi tablets on exercise tolerance are non-inferior to those of trimetazidine in patients undergoing PCI.A total of 668 patients who have undergone PCI for the first time and completed a cardiopulmonary exercise test(CPET)will be enrolled and randomly assigned,in a 1:1 ratio,to receive Yangxinshi tablets(3 tablets,3 times/d)plus trimetazidine-placebo or trimetazidine(20 mg,3 times/d)plus Yangxinshi-placebo for 24 weeks.The primary endpoint is metabolic equivalent of tasks(METs)measured by CPET at 24 weeks after randomization.The secondary endpoints include comprehensive CPET indicators,incidence of major adverse cardiac and cerebrovascular events,and depression(Patient Health Questionnaire-9),anxiety(Generalized Anxiety Disorder-7),and quality of life(Seattle Angina Questionnaire)scores.This study will appraise current clinical evidence on the beneficial effect of Yangxinshi tablets on improving exercise tolerance after PCI and may substantiate their use as an effective pharmacological option for cardiac rehabilitation patients.The HEARTRIP study protocol received approval from the ethics committee of the General Hospital of Northern Theater Command(Shenyang,China).The procedures set out in this protocol are in accordance with the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines.The results will be published following the guidelines of the CONSORT statement in a peer-reviewed scientific journal(Trial registration number:NCT03809273).

Efficacy and safety of Yangxinshi tablet for chronic heart failure:A systematic review and meta-analysis

BACKGROUND The specific benefits of Yangxinshi tablet(YXST)in the treating chronic heart failure(CHF)remain uncertain.AIM To systematically evaluate the efficacy and safety of YXST in the treatment of CHF.METHODS Randomized controlled trials(RCTs)investigating YXST for CHF treatment were retrieved from eight public databases up to November 2023.Meta-analyses of the included clinical studies were conducted using Review Manager 5.3.RESULTS Twenty RCTs and 1845 patients were included.The meta-analysis results showed that the YXST combination group,compared to the conventional drug group,significantly increased the clinical efficacy rate by 23%[relative risk(RR)=1.23,95%CI:1.17-1.29],(P<0.00001),left ventricular ejection fraction by 6.69%[mean difference(MD)=6.69,95%CI:4.42-8.95,P<0.00001]and 6-min walk test by 49.82 m(MD=49.82,95%C:38.84-60.80,P<0.00001),and reduced N-terminal pro-Btype natriuretic peptide by 1.03 ng/L[standardized MD(SMD)=-1.03,95%CI:-1.32 to-0.74,P<0.00001],brain natriuretic peptide by 80.95 ng/L(MD=-80.95,95%CI:-143.31 to-18.59,P=0.01),left ventricular end-diastolic diameter by 3.92 mm(MD=-3.92,95%CI:-5.06 to-2.78,P<0.00001),and left ventricular endsystolic diameter by 4.34 mm(MD=-4.34,95%CI:-6.22 to-2.47,P<0.00001).Regarding safety,neither group reported any serious adverse events during treatment(RR=0.54,95%CI:0.15-1.90,P=0.33).In addition,Egger's test results indicated no significant publication bias(P=0.557).CONCLUSION YXST effectively improves clinical symptoms and cardiac function in patients with CHF while maintaining a favorable safety profile,suggesting its potential as a therapeutic strategy for CHF.