Clinical Efficacy of Traditional Chinese Medicine on Acute Myocardial Infarction——A Prospective Cohort Study

<正>Objective:To evaluate the clinical effects of Chinese medicine(CM) on acute myocardial infarction (AMI) with a prospective cohort study.Methods:A total of 334 AMI patients from January 2007 to March 2009 were consecutively enrolled,and were assigned to a treatment group(169 cases) treated with combined therapy(CM for at least one month and Western medicine) and a control group(165 cases) with Western medicine alone.Clinical data including age,gender,smoking,medical history,infarction area,heart functional classification,CM syndrome scores,blood-stasis syndrome score,primary end-point(death,nonfatal myocardial infarction,and revascularization) and secondary end-point(ischemic stroke,rehospitalization due to angina,heart failure and shock),were collected. CM syndrome scores,blood-stasis syndrome score,primary end-point and secondary end-point were collected during the 6-month follow-up.Kaplan-Meier method was used for the survival analysis.The multifactor analysis was analyzed by Cox proportional hazards regression.Results:At the end of 6-month the CM syndrome score and blood- stasis syndrome score in the treatment group were lower than those in the control group(P0.01),especially the symptoms of chest pain,spontaneous perspiration and insomnia.Rehospitalization rate due to angina during the 6-month follow-up in the treatment group(2.96%) was lower than that in the control group(7.88%,P0.05).Kaplan- Meier survival curve showed that event-free cumulated survival of rehospitalization due to angina during the 6-month follow-up in the treatment group was higher than that in the control group(Log rank 4.700,P=0.03).Cox regression analysis showed that heart dysfunctionhazard ratio(HR)=1.601,95%CI=1.084-2.364,P=0.018]and diabetes mellitus(HR=1.755,95%Cl=1.031-2.989,P=0.038) were hazard factors to end-point,whereas CM(HR 0.405,95% Cl=0.231-0.712,P=0.002),percutaneous coronary intervention(PCI,HR=0.352,95%CI=0.204-0.607,P0.001) and angiotensin converting enzyme(ACE) inhibitors(HR=0.541,95%Cl=0.313-0.936,P=0.028) were protective factors.Conclusions:CM therapy could decrease CM syndrome scores and blood-stasis syndrome score,reduce the rehospitalization rate during 6-month follow-up due to angina.Heart dysfunction and diabetes mellitus were hazard factors to end-point,whereas CM,PCI and ACE inhibitors were protective factors.