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Analysis on outcome of 5284 patients with coronary artery disease: The role of integrative medicine

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单位: [1]China Japan Friendship Hosp, Natl Integrat Med Ctr Cardiovasc Dis, Beijing 100029, Peoples R China [2]China Acad Chinese Med Sci, Xiyuan Hosp, Cardiovasc Dept, Beijing 100091, Peoples R China [3]China Acad Chinese Med Sci, Beijing 100700, Peoples R China
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关键词: Coronary artery disease Secondary prevention Guideline implementation Integrative medicine Traditional Chinese Medicine

摘要:
Ethnopharmacological relevance: Traditional Chinese Medicine (TCM) has a history of thousands of years and has made great contributions to the health and well-being of the people. Integrative medicine (IM) treatment, combing TCM and conventional medicine, has been the most representative characteristic for coronary artery disease (CAD) patients in China, especially those in IM hospitals. However, the secondary prevention status of CAD and the potential benefit of IM therapy in improving CAD prognosis remains unclear. Materials and methods: By means of a unified clinical and research information platform, we collected clinical information of hospitalized patients with CAD in cardiovascular department of 9 IM hospitals in Beijing and Tianjin from January 2003 to September 2006. The primary endpoints were major adverse cardiac events (MACEs) which include all-cause death in hospital and during one-year follow-up, acute myocardial infarction (AMI), percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). The diagnostic and therapeutic status of CAD patients was evaluated based on the latest available clinical guidelines. Meanwhile, a logistic stepwise regression analysis was also used to identify independent prognostic factors. Results: 5284 hospitalized patients with CAD were registered. The top five TCM patterns were in turn blood stasis 79.3%, Qi deficiency 56.5%, phlegm-turbidness 41.1%, Yin deficiency 24.8%, Yang deficiency 11.3%. The standard-reaching rate of CAD patients with hyperlipidemia was 85.6% for total cholesterol, 31.2% for triglyceride, 21.4% for low-density lipoprotein cholesterol, 52.5% for high-density lipoprotein cholesterol, while it was 61.9% and 80.9% in systolic and diastolic blood pressure of CAD with hypertension respectively. The top five commonly used herbs by functions were Qi-tonifying agents 89.25%, blood-activating agents 86.04%. Qi-regulating agents 77.60%, heat-clearing agents 67.50%, dampness-draining agents 65.95%. The herbs commonly used were Salvia miltiorrhiza Bunge 63.10%, Poria 59.99%, Raidx Astragali 49.67%, Radix Paeoniae Rubra 48.71%, peach seed 47.32%, angelica 46.82%, Radix Ligustici Chuanxiong 46.36%, safflower 45.40%, Pinellia 45.30%, glycyrrhiza 41.36%. 90 patients (1.7%) died in hospital, and the overall incidence of endpoints was 6.1% (322/5284). The logistic stepwise regress analysis showed that AM! (OR, 5.62, 95% Cl = 2.56-12.33), heart failure (OR, 2.68, 95% Cl = 1.67-4.29), age >= 60 years (OR, 2.01, 95% CI = 1.22-3.30), and medication of phosphodiesterase inhibitors (OR, 1.67, 95% CI = 1.15-2.42) were independent risk factors for in-hospital mortality and one-year follow-up MACEs, while statins (OR, 0.23,95% Cl = 0.06-0.91) and IM therapy (OR, 0.69.95% Cl = 0.49-0.97) were protective factors. Conclusion: There was still certain gap between the usage of conventional medicine and clinical guideline in IM hospitals of China. Integrative Medicine might have potential benefit for CAD patients in reducing MACEs. However, the scheme of IM intervention and the mechanism of action are still needed to be further determined. (C) 2011 Elsevier Ireland Ltd. All rights reserved.

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出版当年[2011]版:
大类 | 3 区 医学
小类 | 2 区 全科医学与补充医学 3 区 药物化学 3 区 药学 3 区 植物科学
最新[2025]版:
大类 | 2 区 医学
小类 | 1 区 全科医学与补充医学 1 区 药学 2 区 药物化学 2 区 植物科学
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出版当年[2010]版:
Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE Q1 PLANT SCIENCES Q2 PHARMACOLOGY & PHARMACY Q2 CHEMISTRY, MEDICINAL
最新[2024]版:
Q1 CHEMISTRY, MEDICINAL Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE Q1 PHARMACOLOGY & PHARMACY Q1 PLANT SCIENCES

影响因子: 最新[2024版] 最新五年平均[2021-2025] 出版当年[2010版] 出版当年五年平均[2006-2010] 出版前一年[2009版] 出版后一年[2011版]

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第一作者单位: [2]China Acad Chinese Med Sci, Xiyuan Hosp, Cardiovasc Dept, Beijing 100091, Peoples R China
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通讯机构: [1]China Japan Friendship Hosp, Natl Integrat Med Ctr Cardiovasc Dis, Beijing 100029, Peoples R China [*1]China Japan Friendship Hosp, Natl Integrat Med Ctr Cardiovasc Dis, Ying Hua E Rd, Beijing 100029, Peoples R China
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