Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

A systematic review and meta-analysis of Dengzhanxixin injection for coronary heart disease with angina pectoris patients

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.

Advances in Research of Treatment of Angina Pectoris in Coronary Heart Disease from the Method of Dredging Collaterals with Pungent

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.

Network-meta analysis of 9 kinds of patent Chinese medicine for nourishing qi and activating blood in the treatment of angina pectoris of coronary heart disease

Objective:To evaluate the efficacy and safety of Yiqi Huoxue oral Chinese patent medicine in the treatment of angina pectoris.Methods:the databases of EMBASE,PubMed,CNKI,Wanfang and VIP were searched by computer,and the randomized controlled trial(RCT)of Yiqi Huoxue Chinese patent medicine in the treatment of angina pectoris of coronary heart disease(CHD)was searched until December 2019.By using stata15.1 software,the total clinical effective rate,the improvement rate of ECG,the improvement rate of angina pectoris,the attack frequency and duration of angina pectoris were taken as the outcome indicators for network meta analysis and mapping.Results:51 RCTs were included,including 9 kinds of traditional Chinese medicine.The results of network meta analysis showed that:in terms of clinical total effective rate,the order was Shexiang Baoxin Pill(78.2%)>xueshuanxinming tablet>Dengzhan Shengmai capsule>Shengui Capsule>Tongxinluo capsule>Tongmai Yangxin pill>Yangxin tablet>Shexiang Tongxin drop pill>Naoxintong capsule;the improvement of ECG was Tongmai Yangxin pill(85.2%)>Yangxin tablet>Dengzhan Shengmai capsule>Shexiang Tongxin drop pill>Shexiang Baoxin Pill>Tongxinluo gum Capsule>Shengui Capsule>Naoxintong capsule;in order to reduce the frequency and duration of angina pectoris,they are conventional Naoxintong capsule(88.6%)>Shengui Capsule>Tongmai Yangxin pill>Shexiang Baoxin Pill>xueshuanxinmingpian>Tongxinluo capsule>Shexiang Tongxin drop pill>Dengzhan Shengmai capsule;Shexiang Baoxin Pill(66.9%)>Dengzhan Shengmai capsule>Shexiang Tongxin drop pill>Tongxinluo capsule>xueshuanxinmingning capsule Tablet>Tongmai Yangxin pill.Conclusion:Traditional Chinese medicine combined with western medicine has obvious advantages in the treatment of angina pectoris.Shexiang Baoxin Pill,Dengzhan Shengmai capsule and Tongmai Yangxin pill can be given priority.

Sixty-one Cases of Angina Pectoris due to Coronary Heart Disease Treated by External Use of the Paste of Nitrum and Realgar Powder on Zhiyang(GV 9)

In order to inquire into the therapeutic effects of Xiao Shi Xiong Huang San (硝石雄黄散the Nitrum and Realgar Powder), one of the Dunhuang Prescription, on angina pectoris due to coronary heart disease (APCHD), the authors have treated 61 cases of APCHD by externally applying paste of the powder on Zhiyang (GV 9), with another 30 cases of APCHD treated with the nitroglycerin paste on Zhiyang as the controls. The results showed that the total effective rate was 82% and markedly effective rate 31.2% in the treatment group (the Paste of Nitrum and Realgar Powder), and the total effective rate was 46.6% and markedly effective rate 23.2% in the control group (the nitroglycerin paste). The difference in therapeutic effects between the two groups was very significant (P<0.01), indicating that the therapeutic effect of the former was significantly superior to that of the latter.

The efficacy and safety of clopidogrel and aspirin in coronary heart disease with angina pectoris: a systematic review and meta-analysis

Background:To assess the efficacy and safety of clopidogrel combined with aspirin for angina pectoris.Methods:Randomized controlled trials were searched in PubMed,Excerpta Medica Database,the Cochrane Library,China National Knowledge Infrastructure,WANFANG databases and VIP databases from inception to February,2020.Methodological quality was evaluated by the tool of Cochrane collaboration.The meta-analysis was performed in the RevMan 5.3.Results:Fourteen randomized controlled trials with a total of 1,130 participants were included.Meta-analysis showed that for patients with angina pectoris,clopidogrel combined with aspirin had better clinical efficacy than aspirin alone(RR=1.26,95%CI:1.19-1.32,P<0.00001);on the interval time,duration and frequency of angina attack,clopidogrel and aspirin had better effect than aspirin alone(MD=2.09,95%CI:2.07-2.11,P<0.00001;MD=−2.48,95%CI:−3.12 to−1.84,P<0.00001;MD=−1.47,95%CI:−2.59 to−0.35,P=0.01,respectively).Moreover,the available data showed that aspirin and clopidogrel for patients with coronary heart disease with angina pectoris were safer than aspirin alone(RR=0.41,95%CI:0.27-0.61,P<0.0001).Conclusion:Clopidogrel combined with aspirin could be effective for patients with angina pectoris,meanwhile,it is important to be aware of the potential side effects.

A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

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.

Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

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.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

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.

Effects of adjuvant Chinese patent medicine therapy on major adverse cardiovascular events in patients with coronary heart disease angina pectoris:a population-based retrospective cohort study

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.

Association between Nonalcoholic Fatty Liver Disease (NAFLD) and Coronary Artery Disease (CAD) in Patients with Angina Pectoris

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.

Change and significance of fibrinolysis in coronary heart disease patients with angina pactoris

Objectives To study change and the clinical significance of fibrinolysis in coronary heart disease(CHD) patients with angina pactoris(AP).Methods Levels of plas-min plasminogen activator inhibitor-1(PAI-1),tissue-type plasminogen activator(t-PA),fibrinogen(FIB) in 110 CHD patients with AP and 20 normal cases as control group were analyzed in the same ways.Results Levels of PAI-1,FIB in CHD patients with AP were significantly higher than those in control cases,and those of t-PA were significantly lower than control cases;Levels of PAI-1,FIB in UA patients with UA heart events were significantly higher than those in patients with SA,and those of t-PA were significantly lower than patients with SA;Levels of PAI-1,FIB in patients with AP events were significantly higher than those in patients without AP events,and those of t-PA were significantly lower than patients without AP events.Conclusions There was abnormal of fibrinolysis function in CHD patients with AP, specially in patients with UA or with AP events,the abnormal of fibrinolysis might be play an important rule in coronary heart disease(CHD) patients with angina pactoris.

Effect of action research-based exercise training guidance on exercise endurance and readmission rate in patients with stable angina pectoris due to coronary heart disease

Background Stable angina pectoris is a common subtype of coronary heart disease.Patients suffer from chest tightness,chest pain and crushing pain under the inducement of fatigue and emotional agitation.This study aims to investigate the effect of exercise training guidance based on action research on exercise endurance and readmission rate of patients with stable angina pectoris.Methods A retrospective study was conducted on 60 patients with stable angina pectoris due to coronary heart disease admitted to our hospital from February 2020 to November 2023.Patients were divided into a control group of 29 cases(receiving conventional exercise training guidance)and a guidance group of 31 cases(receiving action research-based exercise training guidance).Both groups received continuous training for one month.A comparison was made between the exercise endurance indicators[6-minute walk test distance(6MWT),peak oxygen consumption(peak VO2),anaerobic threshold(AT),exercise duration(ED)],quality of life,and readmission rate within 6 months after intervention in both groups.Results After 1 month of intervention,6MWT,peak VO2,AT and ED were increased in both groups,and those in the guidance group were higher than those in the conventional group(P<0.05).The score of quality of life(The 36-item shot-form health status survey,SF-36)in both groups was increased,and the guidance group scored higher than the conventional group(P<0.05).The readmission rate of patients in the guidance group was 6.45%,which was lower than that in the conventional group(27.59%)(P<0.05).Conclusions The application of action research-based exercise training guidance in patients with stable angina pectoris due to coronary heart disease has significant effects,improving exercise endurance,significantly improving quality of life,and reducing readmission rate,thus having practical value.[S Chin J Cardiol 2024;25(3):162-168]

Efficacy and prognostic impact of Pericarpium Trichosanthis injection combined with nicorandil for intractable angina pectoris in elderly patients: A retrospective study

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.

Plasma levels of omentin-1 and visfatin in senile patients with coronary heart disease and heart failure

Objective:To investigate the alteration of plasma levels of omentin-1 and visfatin in elderly patients with coronary heart disease(CHD)and heart failure.Methods:Plasma omentin-1 and visfatin levels were measured in 90 subjects(29 stable angina pectoris(SAP)cases,30 unstable angina pectoris(UAP)cases and 31 age-and sex-matched healthy controls(age≥60 years)by enzyme-linked immunosorbent assay methods.According to the New York Heart Association classification.59 CHDs were divided into three groups:functional I class,11 cases;functional II/III class,36 cases;and functional IV class,12 cases.Results:The plasma level of omentin-1in CHO patients was significantly lower than thai of the control group.Otnenlin-lin SAP group and UAP group were significantly lower compared to the control group(there was no statistical significance between UAP group and SAP group;P>0.05).The plasma level of visfatin in CHD patients was significandy higher than that of the control group.Similarly,visfatin in SAP group and UAP group were all significantly higher compared to the control group,while there was no statistical significance between UAP group,and SAP group.The plasma omentin-1 level was negatively correlated with SBP(r=-0.264,P<0.05),positively correlated with HDL-c level(r=0.271,P<0.05);the plasma visfatin level was positively correlated with TC(r=0.292,P<0.05),negatively correlated with HDL-c level(r=-0.266,P<0.05).There was a negative correlation between plasma omentin-1 and visfatin levels(r=-0.280,P<0.05).Moreover,multiple linear stepwise regression analysis showed that omentin-1 and visfatin levels might be affected by HDL-c level.Logistic regression analysis showed that visfatin could be an independent risk factor of CHD.Conclusions:Decreased levels of omentin-1 and increased levels of visfatin may be involved in the occurrence and development of CHD.Omentin-1 and visfatin,independently,may be protective and pro-inflammatory cytokines.Additionally,both omentin-1 and visfatin may be related to lipid metabolism.Visfatin may be an independent risk factor of CHD.

Effects of Shenmai Injection on Blood SOD Activity and MDA Level in Senile Patients with Coronary Heart Disease

In order to approach the effects of Shenmai Injection on SOD activity and MDA level in the senile patients with coronary heart disease, 48 cases, who had stenosis of over 70% in more than one branches of the coronary arteries, were assigned randomly into a treatment group (given Shenmai Injection plus the routine treatment) and a control group (given the routine treatment only). The superoxide dismutase (SOD) activity and malondialdehyde (MDA) level were determined before treatment and at the end of a 3-week treatment. The results showed that in the treatment group, the SOD activity was significantly increased (P＜0.05) and the MDA level markedly decreased (P＜0.01) in the treatment group. It can be concluded that Shenmai Injection may enhance the antioxidant ability of the senile patients with coronary heart disease.

Misdiagnosis of Angina Pectoris Due to Severe Coronary Artery Disease: An Anecdotal Case

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.

CLINICAL OBSERVATION AND STUDY OF MECHANISMSOF ACUPUNCTURE TREATMENT OFCORONARY HEART DISEASE

In the present paper, 80 in-patients with coronary heart disease were randomly assignedto acupuncture group, Western medicine group and acupuncture transient effect group, and 30 healthyblood donors were served as control group. At the same time of further observation on clinical therapeutic effects of acupuncture, effects of acupuncture on contents of blood monoamine, serotonin(5-HT), noradrenaline(NE) and dopamine(DA) for analyzing mechanisms of acupuncture treatment. Results indicated that 1. Therapeutic effects of acupuncture on angina pectoris and changes of ST-T segment of ischemic electrocardiogram (ECG) in patients of coronary heart disease were superior to thosein the Western medicine group, suggesting that acupuncture improves markedly left ventricular function; 2. The contents of blood 5-HT, 5-hydroxyindol acetic acid (5-HIAA ) and NE in patients ofcoronary heart disease were significantly higher than those in the healthy blood-donors; 3. After onetherapeutic course, the contents of blood 5-HT, 5-HIAA and NE in the acupuncture group were obviously lower than those before treatment and in the Western medicine respectively, indicating that themechanism of acupuncture treating coronary heart disease is related with regulatory effects of acupuncture on blood contents of 5-HT and NE.

Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome:a network Meta-anal

OBJECTIVE:To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegmstasis coronary heart disease by a network Meta-analysis.METHODS:Randomized controlled trials(RCTs)on clinical efficacy of CHD angina pectoris with interaction of phlegm and blood stasis were searched in PubMed,Springer,the Cochrane Library and Chinese-language databases China National Knowledge Infrastructure,China Science and Technology Journal Database,and Wanfang Data from their inception to December 2021.Literature was screened and literature bias risk was assessed by RevMan5.4 software.The overall response rate,the duration of angina attack,the levels of serum lipids such as total cholesterol(TC),triglyceride(TG),low density lipoprotein cholesterol(LDL-C),and high density lipoprotein cholesterol(HDL-C),and expression of hypersensitive C-reactive protein(hs-CRP)were selected as outcome indicators for network Meta-analysis and mapped using Stata15.1 software.RESULTS:Totally,26 RCTs were included,involving 2098 participants.There were 6 TCM formulas with the effects of dispelling phlegm and removing blood stasis.Taking conventional Western Medicine as the common intervention measures,the results showed that the overall response improvement rate from high to low was displayed as modified Xiaoxianxiong decoction(小陷胸汤,MXD),Danlou tablet(丹蒌片,DT),modified Gualou Xiebai Banxia decoction(瓜蒌薤白半夏汤,MGXBD),modified Wendan decoction(温胆汤,MWD),modified Zhishi Xiebai Guizhi decoction(枳实薤白桂枝汤,MZXGD),and modified Erchen decoction(二陈汤,MED).The sequence of angina attack duration improvement from high to low was MZXGD,MGXBD,DT,MWD,MXD.The sequence of TC improvement from high to low was MZXGD,MED,DT,and MGXBD.Sequence of improving TG from high to low was MED,MZXGD,MGXBD,and DT.For LDL-C improvement,the effect from good to poor was MZXGD,MGXBD,DT,and MED.With regard to HDL-C improvement,the effect was ranked as MED,MZXGD,MGXBD,and DT from good to poor.hs-CRP expression from high to low was MZXGD,MXD,MED,MWD,and MGXBD.CONCLUSION:TCM formula with the effects of dispelling phlegm and removing blood stasis combined with conventional Western Medicine has obvious advantages in treating CHD angina pectoris with interaction of phlegm and blood stasis.MZXGD has great potential in increasing the overall response rate,reducing Duration of angina attack improving blood lipids,and reducing inflammatory factors.However,due to the limitations of extant studies,the conclusions of this study need to be confirmed by numerous reasonably-designed RCTs.

Self-management of coronary heart disease in older patients after elective percutaneous transluminal coronary angioplasty

Objective To explore how older patients self-manage their coronary heart disease （CHD） aider undergoing elective percutaneous transluminal coronary angioplasty （PTCA）. Methods This mixed methods study used a sequential, explanatory design and recruited a convenience sample of patients （n = 93） approximately three months after elective PTCA. The study was conducted in two phases. Quantitative data collected in Phase 1 by means of a self-administered survey were subject to univariate and bivariate analysis. Phase 1 findings in- formed the purposive samplhag for Phase 2 where ten participants were selected from the original sample for an in-depth interview. Qualita- tive data were analysed using thematic analysis. This paper will primarily report the findings from a sub-group of older participants （n = 47） classified as 65 years of age or older. Results 78.7% （n = 37） of participants indicated that they would manage recurring angina symptoms by taking glyceryl trinitrate and 34% （n = 16） thought that resting would help. Regardless of the duration or severity of the symptoms 40.5% （n = 19） would call their general practitioner or an emergency ambulance for assistance during any recurrence of angina symptoms. Older participants weighed less （P = 0.02） and smoked less （P = 0.01） than their younger counterparts in the study. Age did not seem to affect PTCA patients＇ likelihood of altering dietary factors such as fruit, vegetable and saturated fat consumption （P = 0.237）. Conclusions The findings suggest that older people in the study were less likely to know how to correctly manage any recurring angina symptoms than their younger counterparts but they had fewer risk factors for CHD. Age was not a factor that influenced participants＇ likelihood to alter lifestyle factors.