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.

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.

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.

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.

Highly sensitive troponin I assay in the diagnosis of coronary artery disease in patients with suspected stable angina

BACKGROUND Evaluation of suspected stable angina patients with probable coronary artery disease(CAD)in the community is challenging.In the United Kingdom,patients with suspected stable angina are referred by community physicians to be assessed by specialists within the hospital system in rapid access chest pain clinics(RACPC).The role of a highly sensitive troponin I(uscTnI)assay in the diagnosis of suspected CAD in a RACPC in a“real-life”setting in a non-academic hospital has not been explored.AIM To examine the diagnostic value of uscTnI(detection limit 0.12 ng/L,upper reference range 8.15 ng/L,and detected uscTnI in 96.8%of the reference population),in the evaluation of stable CAD in a non-selected patient group,with several co-morbidities,who presented to the RACPC.METHODS One hundred and seventy two RACPC patients were assigned to either functional or anatomical testing according to the hospital protocol.RESULTS The investigations offered to patients were exercise tolerance test 7.6%,24 h ECG 1.2%,Echocardiogram 14.5%,stress echocardiogram 8.1%,coronary computed tomography angiography(CCTA)12.8%,coronary angiogram 13.4%,17.4%were diagnosed with non-cardiac chest pain,3.5%treated as stable angina,8.2%reviewed by cardiologists,electronic medical records were not available in 10.4%.Receiver operating characteristic curves for CAD used uscTnI values measured in patients who underwent functional testing,angiogram or CCTA.Values>0.52 ng/L showed 100%sensitivity and at>11.6 ng/L showed 100%specificity.In the range>0.52-11.6 ng/L,uscTnI may not have the same diagnostic potential.In patients assigned to coronary angiogram higher concentrations of uscTnI was associated with severe CAD.Low levels of uscTnI and low pre-test probability of CAD(QRISK3)may decrease patient numbers assigned to CCTA.CONCLUSION The uscTnI diagnostic cut-off values in a RACPC will depend on patient population and their presenting co-morbidity.In the presence of clinical comorbidities and previous CAD the uscTnI needs to be used in conjunction with clinical assessment.

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.

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.

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.

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]

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.

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.

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.

Sudden Cardiac Death in Adult Patients with Stable Ischemic Heart Disease

There are approximately one half million patients with stable ischemic heart disease(SIHD)in the United States.Patients with stable ischemic heart disease who die suddenly do not maintain a Stable Ischemic profi le.Benchimol,et al.,reported 319 consecutive stable angina patients without clinical heart failure or a recent myocardial infarction but who had multiple risk factors and proven coronary disease which made them more prone to acute myocardial infarction or unstable angina.In the APSIS(angina prognosis in Stockholm)study,Hjemdahl reported that signs of ischemia or previous manifestations of coronary artery disease,i.e.,myocardial infarction or revascularization,were found in 69%of both male and female patients at baseline.Little,retrospectively reported that minor plaques may disrupt and result in unstable angina or occlusive coronary disease which then may result in acute myocardial infarction.Stable angina patients,by defi nition,are stable and are not high risk unless they have multiple factors or which may make them prone to evolve an acute coronary syndrome or develop a serious arrhythmia but sudden death does occur in some patients.

Contemporary Management of Patients with Stable Ischemic Heart Disease

The overall goals of therapy for patients with stable ischemic heart disease are to minimize the likelihood of death while maximizing health and function.Initial risk assessment with noninvasive testing is indicated to determine whether invasive evaluation is needed in addition to medical therapy.All patients with stable ischemic heart disease need optimal medical therapy,which includes risk factor management with lifestyle modifi cations and pharmacologic therapy.First-line pharmacologic therapy is focused on preventing myocardial infarction and death with antiplatelet agents,lipid-lowering therapy,and antihypertensive therapies.In addition,antianginal therapy and anti-ischemic therapy are indicated to alleviate symptoms,reduce ischemia,and improve quality of life.The commonly used antianginal agents include nitrates,beta-blockers,calcium channel blockers,and ranolazine.When medical therapy is not adequate to relieve angina,revascularization with percutaneous coronary intervention or coronary artery bypass grafting is indicated.We review the indications and evidence for antianginal agents and other therapies for angina.

Stable ischemic heart disease in the older adults

1 Introduction Ischemic heart disease is caused by atherosclerotic and/or thrombotic obstruction of coronary arteries. Clinical spec- trum of ischemic heart disease expands from asymptomatic atherosclerosis of coronary arteries to acute coronary syn- dromes （ACS） including unstable angina, acute myocardial infarction （non-ST elevation myocardial infarction and ST elevation myocardial infarction）. Stable ischemic heart dis- ease （SIHD） refers to patients with known or suspected SIHD who have no recent or acute changes in their symp- tomatic status, suggesting no active thrombotic process is underway.

Trial Study on DENG Tie-tao's Coronary Heart Disease Capsules in Improving Patients' Quality of Life

Objective： To assess the efficacy of the Coronary Heart Disease （CHD） Capsules worked out by Prof. Deng -- in improving quality of life of CHD patients of qi deficiency with phlegm and blood stasis syndrome. Method： According to the WHO＇s diagnosis criteria of CHD, a total of 93 stable angina patients were divided into 3 groups using the single blinded method. The groups were evenly distributed into CHD Capsule treated group （CHDC）, isosorbide dinitrate control group （ID）, and Compound Prescription Danshen Droplet Pills control group （CPDDP）. Two courses of treatment lasting for 6 months were given. During the courses of treatment, the following parameters were observed： clinical symptoms of angina pectoris, ECG change, treadmill exercise test, 36 items in short form of health survey （SF-36） and Seattle Angina Questionnaire （SAQ） scale. Results： After 6 months of treatment, all the three groups showed good curative effect in angina pectoris, ECG and treadmill exercise test, differences between them had no statistical significance. The CHDC group showed a better result in nitro-glycerine stopping or alleviation rate and in improving symptoms than the other groups （P〈0.05）. The general health, vitality, role-emotional, mental health and reported health transition in the CHDC group were significantly better than those in the control groups （P〈 0.05）. The scores in physiological functioningrole, physiological function and pain alleviation were not different among the three groups. Conclusion. Prof. DENG Tie-tao＇s CHDC is effective in treating CHD with qi deficiency, phlegm and blood stasis and also in improving the quality of life. CHDC is more suitable to be used in long-term treatment than isosorbide dinitrate. The SF-36 and SAQ can be used to appraise the curative effect of traditional Chinese medicine agents for CHD angina pectoris.

Treatment of unstable angina with trimetazidine

Objective To evaluate the clinical therapeutic effects oftrimetazidine on the treatment of unstable angina （UA） as well as its effects on endothelin- 1 level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group （n =60） and the control group （n =60）, the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells （CEC） and endothelin- 1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1） The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%,respectively （P〈0.05）, and the excellence rates were 36.7% and 15% （P〈0.01）respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%,respectively （P〈0.05）, and the excellence rates were 30.0% and 11.7%, respectively （P〈0.01）. 2） The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased （P〈0.05）, but the decreases in the trimetazidine group were even significant （P〈0.01 ）. 3） The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% （P〈0.05）, respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively （P〈0.05）, and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively （P〈0.05）. Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.

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.