Traditional Chinese medicine found to decrease post-heart-attack risk

A new study has found that a traditional Chinese medicine reduced complications following a serious heart attack, including future heart attacks, stroke and death, and its benefits can last up to a year. The results pave the way for further exploring and refining the treatment.

An ST-elevation myocardial infarction (STEMI) is the deadliest type of heart attack, resulting from a total or near-total blockage of a coronary artery supplying oxygen-rich blood to the heart muscle. A STEMI can cause permanent damage to the heart within a few hours and increases the risk of further heart attacks, arrhythmias, heart failure and stroke.

Researchers at UT Southwestern Medical Center in Texas have undertaken one of the first Western-style clinical trials of tongxinluo, a traditional Chinese medicine, to ascertain whether it reduces the risk of major cardiac and cerebrovascular complications following a STEMI.

“Many currently used drugs were first recognized by the study of natural or home remedies,” said Eric Peterson, one of the study’s co-authors. “While we do not know the exact active ingredient and mechanism of action in the traditional Chinese medicine that caused these benefits, it does point us toward exploring and refining this therapy.”

Tongxinluo, which translates to “to open the network of the heart,” has long been used in China as a traditional therapy to treat patients who’ve had heart attacks and/or strokes. In 1996, the Chinese State Food and Drug Administration, based on promising results in cellular and animal models, approved the use of tongxinluo for angina and stroke. The medicine is a mixture of herb and animal extracts, including ginseng, leech, scorpion, cicada, centipede, cockroach, sandalwood, and frankincense.

The researchers recruited 3,777 patients at 124 clinical centers in China who’d had a STEMI between 2019 and 2020. They were treated within hours of the heart attack by surgical or chemical removal of the coronary artery blood clot. Over the next year, in addition to standard treatments such as aspirin or medications like beta blockers, half of the patients were randomized to receive tongxinluo. The other half took a placebo that looked, smelled, and tasted like tongxinluo.

Over 12 months, the researchers tracked the incidence of major adverse cardiac and cerebrovascular events (MACCEs), an umbrella term combining cardiac death, repeated heart attacks, stroke, and emergency procedures to restore blood flow to the heart. They found that, at 30 days, MACCEs were about 30% lower in those patients who took tongxinluo compared to the placebo group. The benefits persisted for one year after discharge from clinical care. The patients taking tongxinluo also had a lower risk of individual components of the MACCEs, including a 25% decreased risk of cardiac death. No major side effects from tongxinluo were observed.

“Many drugs have failed to achieve effects as impressive as this traditional Chinese medicine,” said Ying Xian, another of the study’s co-authors. “Tongxinluo deserves further study.”

Because of the number of components that make up tongxinluo, further study will focus on determining which are responsible for these protective effects and how they reduce the risk of post-heart attack complications. Before the traditional medicine can gain FDA approval, the study’s findings will need to be replicated in other populations.

The study was published in the journal JAMA.

Source: UT Southwestern Medical Center

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