Liu Zi-Hao, Xing Wen-Long, Liu Hong-Xu, Shang Ju-Ju, Li Ai-Yong, Zhou Qi, Zhang Zhen-Min, Li Zhi-Bao, Chen Ke-Ji
Cardiovascular Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, 100010, China.
Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China.
Chin J Integr Med. 2025 Mar;31(3):206-214. doi: 10.1007/s11655-024-4000-5. Epub 2024 Dec 2.
To evaluate the immediate effect of Kuanxiong Aerosol (KXA) on perioperative coronary microcirculation in patients with unstable angina (UA) suffering from elective percutaneous coronary intervention (PCI).
From February 2021 to July 2023, UA inpatients who underwent PCI alone in the left anterior descending (LAD) branch were included. Random numbers were generated to divide patients into the trial group and the control group at a ratio of 1:1. The index of coronary microcirculation resistance (IMR) was measured before PCI, and the trial group was given two sprays of KXA, while the control group was not given. IMR was measured again after PCI, cardiac troponin I (cTnI) and creatine kinase isoenzyme-MB (CK-MB) were detected before and 24 h after surgery, and major cardiovascular adverse events (MACEs) were recorded for 30 days. The data statistics and analysis personnel were blinded.
Totally 859 patients were screened, and 62 of them were involved into this study. Finally, 1 patient in the trial group failed to complete the post-PCI IMR and was excluded, 30 patients were included for data analysis, while 31 patients in the control group were enrolled in data analysis. There was no significant difference in baseline data (age, gender, risk factors, previous history, biochemical index, and drug therapy, etc.) between the two groups. In addition, differences in IMR, cTnI and CK-MB were not statistically significant between the two groups before surgery. After PCI, the IMR level of the trial group was significantly lower than that of the control group (19.56 ± 14.37 vs. 27.15 ± 15.03, P=0.048). Besides, the incidence of perioperative myocardial injury (PMI) was lower in the trial group, but the difference was not statistically significant (6.67% vs. 16.13%, P=0.425). No MACEs were reported in either group.
KXA has the potential of improving coronary microvascular dysfunction. This study provides reference for the application of KXA in UA patients undergoing elective PCI. (Registration No. ChiCTR2300069831).
评估宽胸气雾剂(KXA)对择期经皮冠状动脉介入治疗(PCI)的不稳定型心绞痛(UA)患者围手术期冠状动脉微循环的即时影响。
纳入2021年2月至2023年7月仅在左前降支(LAD)分支接受PCI的UA住院患者。通过生成随机数将患者按1:1的比例分为试验组和对照组。在PCI术前测量冠状动脉微循环阻力指数(IMR),试验组给予两次KXA喷雾,对照组未给予。PCI术后再次测量IMR,术前及术后24小时检测心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶-MB(CK-MB),并记录30天内的主要心血管不良事件(MACE)。数据统计和分析人员设盲。
共筛选859例患者,其中62例纳入本研究。最终,试验组1例患者未完成PCI术后IMR测量被排除,30例患者纳入数据分析,对照组31例患者纳入数据分析。两组基线数据(年龄、性别、危险因素、既往史、生化指标和药物治疗等)无显著差异。此外,两组术前IMR、cTnI和CK-MB差异无统计学意义。PCI术后,试验组IMR水平显著低于对照组(19.56±14.37 vs. 27.15±15.03,P=0.048)。此外,试验组围手术期心肌损伤(PMI)发生率较低,但差异无统计学意义(6.67% vs. 16.13%,P=0.425)。两组均未报告MACE。
KXA具有改善冠状动脉微血管功能障碍的潜力。本研究为KXA在择期PCI的UA患者中的应用提供参考。(注册号:ChiCTR2300069831)