Wang Shao-Li, Wang Cheng-Long, Wang Pei-Li, Xu Hao, Chen Ke-Ji, Shi Da-Zhuo
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China.
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100081, China.
Evid Based Complement Alternat Med. 2015;2015:639267. doi: 10.1155/2015/639267. Epub 2015 Oct 1.
Aims. The priority of Chinese herbal medicines (CHMs) plus conventional treatment over conventional treatment alone for acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI) was documented in the 5C trial (chictr.org number: ChiCTR-TRC-07000021). The study was designed to evaluate the 10-year effectiveness of CHMs plus conventional treatment versus conventional treatment alone with decision-analytic model for ACS after PCI. Methods and Results. We constructed a decision-analytic Markov model to compare additional CHMs for 6 months plus conventional treatment versus conventional treatment alone for ACS patients after PCI. Sources of data came from 5C trial and published reports. Outcomes were expressed in terms of quality-adjusted life years (QALYs). Sensitivity analyses were performed to test the robustness of the model. The model predicted that over the 10-year horizon the survival probability was 77.49% in patients with CHMs plus conventional treatment versus 77.29% in patients with conventional treatment alone. In combination with conventional treatment, 6-month CHMs might be associated with a gained 0.20% survival probability and 0.111 accumulated QALYs, respectively. Conclusions. The model suggested that treatment with CHMs, as an adjunctive therapy, in combination with conventional treatment for 6 months might improve the long-term clinical outcome in ACS patients after PCI.
目的。在5C试验(中国临床试验注册中心编号:ChiCTR-TRC-07000021)中,已证明经皮冠状动脉介入治疗(PCI)后,中药(CHMs)联合传统治疗相对于单纯传统治疗对急性冠状动脉综合征(ACS)的优先性。本研究旨在使用决策分析模型评估CHMs联合传统治疗与单纯传统治疗对PCI术后ACS患者的10年疗效。方法与结果。我们构建了一个决策分析马尔可夫模型,比较PCI术后ACS患者接受6个月CHMs联合传统治疗与单纯传统治疗的情况。数据来源为5C试验及已发表的报告。结果以质量调整生命年(QALYs)表示。进行敏感性分析以检验模型的稳健性。该模型预测,在10年期间,接受CHMs联合传统治疗的患者生存概率为77.49%,而单纯接受传统治疗的患者生存概率为77.29%。与传统治疗相结合,6个月的CHMs可能分别使生存概率提高0.20%,累积QALYs增加0.111。结论。该模型表明,CHMs作为辅助治疗与传统治疗联合应用6个月,可能改善PCI术后ACS患者的长期临床结局。