Prospective Observational Study Of Traditional Chinese Medicine Intervention On Cardiovascular Composite Endpoints After PCI For Coronary Heart Disease

Objective:To systematically evaluate the impact of traditional Chinese medicine(TCM)on cardiovascular composite endpoint events in patients after PCI,so as to provide evidence-based basis for the long-term efficacy.Methods:This study adopts prospective,observational registration study method,selected patients diagnosed with coronary heart disease and accepted PCI therapy in Fuwai hospital Chinese academy of medical sciences from September 2016 to August 2017,collected their baseline data and follow-up 2 years.According to actual treatment strategies,patients can be divided into western medicine alone group and TCM plus western medicine group.The cox regression model was established to evaluate the efficacy of the two groups.The primary endpoint was cardiovascular composite endpoint events in two years,including all-cause death,revascularization and myocardial infarction(MI).The secondary endpoint were angina symptom scores and TCM syndrome scale scores.Meanwhile,cardiovascular readmission and stroke were observed.Results:A total of 6000 patients with coronary heart disease after PCI were enrolled in this study,among which 5453 patients were had followed up,2932 patients(53.8%)in western medicine alone group and 2521 patients(46.2%)in TCM plus western medicine group.In terms of the primary endpoint,cox regression analysis showed that,compared with conventional treatment alone group,the TCM plus conventional treatment group could reduce the risk of cardiovascular composite endpoint events by 27.0%(HR=0.800;95%CI,0.624-1.027;P=0.080).Thereinto compared with western medicine alone group,the risk of revascularization and the risk of all-cause death were reduced by 16.3%(HR=0.837;95%CI,0.717-0.978 P=0.025)and 88.9%(HR=0.111;95%CI,0.051-0.241;P=0.000)in TCM plus western medicine group.In terms of the secondary endpoint,the T test results showed that there was no significant difference in angina symptom score between the western medicine alone group and the TCM plus western medicine group(P=0.467).TCM syndrome score in the TCM plus western medicine group was significantly lower than that in the western medicine alone group(P=0.000).In terms of other results,cox regression showed that compared with western medicine alone group,TCM plus western medicine group could reduce the risk of cardiovascular readmission by 17.2%(HR=0.828;95%CI,0.711-0.964;P=0.015);There was no significant statistical difference in the occurrence of stroke between western medicine alone group and TCM plus western medicine group(HR=1.051;95%CI,0.592-1.864;P=0.866).Conclusion:For the patients after PCI,on the basis of conventional western medicine treatment,combining the TCM treatment is conducive to reducing the risk of cardiovascular composite endpoint events including all-cause death,revascularization and myocardial infarction,reducing the risk of cardiovascular readmission and alleviating the clinical symptoms of patients.At the same time,TCM plus western medicine treatment did not increase the risk of stroke compared with western medicine alone treatment.Therefore,the combination of TCM on the basis of conventional western medicine can bring significant benefits to patients.