Objective  To explore the prognostic impact of Qili Qiangxin capsules (QLQX) in patients with ST-segment elevation myocardial infarction (STEMI).

Methods  Retrospective collecting the clinical data of STEMI patients treated at PingAn Hospital affiliated to Hebei Medical University from January 2020 to January 2022, divided into QLQX group and non- QLQX group according to treatment plan. Follow-up patients for 1 year, with the main endpoint being major adverse cardiovascular and cerebrovascular events (MACCEs) at 30  d and 1 year; The secondary endpoints were cardiogenic death, myocardial reinfarction, emergency coronary revascularization, stroke, and major bleeding at 30 d and 1 year, as well as severe STEMI complications (30 d), re-admission due to heart failure (1 year), and all-cause mortality (1 year).

Results  A total of 210 STEMI patients were included (125 in the QLQX group and 85 in the non QLQX group). Univariate or Kaplan Meier analysis showed that the MACCE, cardiogenic death, malignant arrhythmia at 30 d, myocardial reinfarction, re-admission due to heart failure, and all-cause mortality rates in the QLQX group were significantly lower than those in the non QLQX group at 30 d and 1 year (P<0.05), while there were no significant differences in the incidence of other observed endpoint events between the two groups (P>0.05). In addition, QLQX may be a protective factor for MACCEs in STEMI patients (30 d: HR=0.157, 95%CI 0.032 to 0.756, P=0.021; 1 year: HR=0.208, 95%CI 0.087 to 0.497, P=0.014).

Conclusion  QLQX adjuvant therapy may improve MACCEs in STEMI patients.

1.Heusch G. Myocardial ischaemia-reperfusion injury and cardioprotection in perspective[J]. Nat Rev Cardiol, 2020, 17(12): 773-789. DOI: 10.1038/s41569-020-0403-y.

2.Figtree GA, Vernon ST, Hadziosmanovic N, et al. Mortality in STEMI patients without standard modifiable risk factors: a sex-disaggregated analysis of SWEDEHEART registry data[J]. Lancet, 2021, 397(10279): 1085-1094. DOI: 10.1016/S0140-6736(21)00272-5.

3.Hillerson D, Li S, Misumida N, et al. Characteristics, process metrics, and outcomes among patients with ST-elevation myocardial infarction in rural vs urban areas in the US: a report from the US national cardiovascular data registry[J]. JAMA Cardiol, 2022, 7(10): 1016-1024. DOI: 10.1001/jamacardio.2022.2774.

4.Ibanez B, James S, Agewall S, et al. 2017ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the european society of cardiology (ESC)[J]. Eur Heart J, 2018, 39(2): 119-177. DOI: 10.1093/eurheartj/ehx393.

5.Lawton JS, Tamis-Holland JE, Bangalore S, et al. 2021ACC/AHA/SCAI guideline for coronary artery revascularization: executive summary: a report of the American college of Cardiology/American heart association joint committee on clinical practice guidelines[J]. Circulation, 2022, 145(3): e4-e17. DOI: 10.1161/CIR. 0000000000001039.

6.Yang YJ, Li XD, Chen GH, et al. Traditional Chinese medicine compound (Tongxinluo) and clinical outcomes of patients with acute myocardial infarction: The CTS-AMI randomized clinical trial[J]. JAMA, 2023, 330(16): 1534-1545. DOI: 10.1001/jama.2023.19524.

7.Cheng WK, Wang L, Yang T, et al. Qiliqiangxin capsules optimize cardiac metabolism flexibility in rats with heart failure after myocardial infarction[J]. Front Physiol, 2020, 17: 11: 805. DOI: 10.3389/fphys.2020.00805.

8.纪晓迪, 吴爱明, 吕梦, 等. 基于miRNA-133a/TGF-β1/Smads信号通路探讨芪苈强心胶囊对心肌梗死大鼠心肌纤维化的作用机制[J]. 海南医学院学报, 2022, 28(21): 1608-1613. [Ji XD, Wu AM, Lyu  M, et al. Based on miRNA-133a/TGF-β1 exploring the mechanism of Qili Qiangxin capsules on myocardial fibrosis in myocardial infarction rats through the Smads signal pathway[J]. Journal of Hainan Medical College, 2022, 28(21): 1608-1613.] DOI: 10.13210/j.cnki.jhmu. 20220331.002.

9.纪晓迪, 杨丁, 崔喜元, 等. 芪苈强心胶囊对心肌梗死大鼠心脏IP3Rs/GRP75/VDAC1基因调控的机制研究[J]. 海南医学院学报, 2023, 29(11): 815-824. [Ji XD, Yang D, Cui XY, et al. The mechanism study of Qili Qiangxin capsules on the regulation of IP3Rs/GRP75/VDAC1 gene in the heart of myocardial infarction rats[J]. Journal of Hainan Medical College, 2023, 29(11): 815-824.] DOI: 10.13210/j.cnki.jhmu.20221116.002.

10.罗心霞, 马石楠, 周君阳, 等. 芪苈强心通过p-Erk/Nrf2通路对心肌梗死小鼠细胞凋亡的影响[J]. 中成药, 2020, 42(9): 2306-2311. [Luo XX, Ma SN, Zhou JY, et al. The effect of Qili Qiangxin on cell apoptosis in myocardial infarction mice through the p-Erk/Nrf2 pathway[J]. Chinese Traditional Patent Medicine, 2020, 42(9): 2306-2311.] DOI: 10.3969/j.issn.1001-1528.2020.09.011.

11.张宁,毋会芃,安斌. 重组人脑利钠肽联合芪苈强心胶囊治疗老年急性心肌梗死合并心力衰竭的临床价值 [J]. 中华老年心脑血管病杂志, 2022, 24(7): 685-688. [Zhang N, Wu HP, An B. Clinical value of recombinant human brain natriuretic peptide combined with Qili Qiangxin capsules in the treatment of elderly acute myocardial infarction with heart failure[J]. Chinese Journal of Geriatric Heart Brain and Vessel Diseases, 2022, 24(7): 685-688.] DOI: 10.3969/j.issn.1009-0126.2022.07.004.

12.熊维, 蔡红专. rhBNP联合芪苈强心胶囊对急性心肌梗死合并心力衰竭病人心功能的影响[J]. 中西医结合心脑血管病杂志, 2021, 19(6): 967-969. [Xiong W, Cai HZ. The effect of rhBNP combined with Qili Qiangxin capsules on cardiac function in patients with acute myocardial infarction and heart failure[J]. Journal of Integrated Traditional Chinese and Western Medicine in Cardiovascular and Cerebrovascular Diseases, 2021, 19(6): 967-969.] DOI: 10.12102/j.issn.1672-1349.2021.06.019.

13.赵闽. 芪苈强心胶囊联合缬沙坦治疗对急性前壁心肌梗死患者心功能及不良心血管事件的影响[J]. 湖北中医药大学学报, 2021, 23(4): 58-60. [Zhao M. The effect of Qili Qiangxin capsules combined with valsartan on cardiac function and adverse cardiovascular events in patients with acute anterior myocardial infarction[J]. Journal of Hubei University of Traditional Chinese Medicine, 2021, 23(4): 58-60.] DOI: 10.3969/j.issn.1008987x.2021.04.15.

14.王佳南, 吴兵, 刘慧兰, 等. 芪苈强心胶囊对急性前壁心肌梗死左心功能、血清亲环素A及不良心血管事件的影响分析[J]. 中华中医药学刊, 2020, 38(10): 218-221. [Wang JN, Wu B, Liu HL, et al. Analysis of the effects of Qili Qiangxin capsules on left heart function, serum cyclophilin A, and adverse cardiovascular events in acute anterior myocardial infarction[J]. Chinese Journal of Traditional Chinese Medicine, 2020, 38(10): 218-221.] DOI: 10.13193/j.issn.1673-7717.2020.10.051.

15.李英, 胡晴. 芪苈强心胶囊联合间歇性低氧治疗对急性ST段抬高型心肌梗死经皮冠状动脉介入术后炎性反应及血管活性物质的影响[J]. 河北中医, 2020, 42(6): 873-877. [Li Y, Hu Q. The effect of Qili Qiangxin capsules combined with intermittent hypoxia treatment on inflammatory response and vasoactive substances after percutaneous coronary intervention in acute ST segment elevation myocardial infarction[J]. Hebei Traditional Chinese Medicine, 2020, 42(6): 873-877.] DOI: 10.3969/j.issn.1002-2619.2020.06.016.

16.Levine GN, Bates ER, Blankenship JC, et al. 2015 ACC/AHA/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American college of Cardiology/American heart association task force on clinical practice guidelines and the society for cardiovascular angiography and interventions[J]. Circulation, 2016, 133(11): 1135-1147. DOI: 10.1161/CIR.0000000000000336.

17.高艳霞，李小虎. 芪苈强心胶囊治疗舒张性心力衰竭的临床观察[J]. 中国现代医生, 2016, 54(7): 107-109. [Gao YX, Li XH. Clinical observation of Qili Qiangxin capsules in the treatment of diastolic heart failure[J]. Chinese Modern Doctor, 2016, 54(7): 107-109.] DOI: CNKI:SUN:ZDYS.0.2016-07-034.

18.钱玉红, 李争, 王敏, 等. 芪苈强心胶囊对阿霉素所致心力衰竭大鼠氧化损伤的影响[J]. 疑难病杂志, 2014, 13(6): 625-633. [Qian YH, Li Z, Wang M, et al. The effect of Qili Qiangxin capsules on oxidative damage in rats with heart failure induced by doxorubicin[J]. Journal of Difficult Diseases, 2014, 13(6): 625-633.] DOI: 10.3969/j.issn.1671-6450.2014.06.025.

19.王生平, 冯胜红, 冯永生, 等. 芪苈强心胶囊佐治缺血性心肌病左心衰竭的临床价值[J]. 疑难病杂志, 2015, 14(12): 1284-1287. [Wang SP, Feng SH, Feng YS, et al. The clinical value of Qili Qiangxin capsules in the treatment of left heart failure in ischemic cardiomyopathy[J]. Journal of Difficult Diseases, 2015, 14(12): 1284-1287.] D0I: 10.3969/j.issn.1671-6450.2015.12.023.

20.陈要起, 穆金兴, 陈洪波, 等. 芪苈强心胶囊对糖尿病心肌病患者预后的影响[J]. 海南医学, 2017, 28(7): 1-4. [Chen YQ, Mu JX, Chen HB, et al. Effect of Qili Qiangxin capsules on the prognosis of patients with diabetes cardiomyopathy[J]. Hainan Medicine, 2017, 28(7): 1-4.] DOI: 10.3969/j.issn.1003-6350.2017.07.012.

21.马小林,黄政,方存明, 等. 芪苈强心胶囊通过TLR4/NF-κB通路减轻大鼠心肌炎性反应及损伤[J]. 疑难病杂志, 2021, 20(1): 37-40, 46. [Ma XL, Huang Z, Fang CM, et al. Qili Qiangxin capsules passed TLR4/NF-κB pathway reduces inflammatory response and injury in rat cardiomyopathy[J]. Journal of Difficult Diseases, 2021, 20(1): 37-40, 46.] DOI: 10.3969/j.issn.1671-6450. 2021.01.008.