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- an intense ST-segment elevation myocardial infarction (STEMI) is a serious type of heart attack that occurs when a coronary artery suddenly becomes completely blocked.
- Investigators recently analyzed how tongxinluo, a traditional Chinese medicine that contains ginseng, might help reduce STEMI symptoms.
- People who took Tongxinluo capsules saw significant improvements in their health after 30 days and one year of use as combined therapy with STEMI guideline-directed treatments.
Tongxinluo is a traditional Chinese medicine formulation that has been widely used for thousands of years. The compound has shown cardioprotective potential in small amounts in vitroAnimal and human studies, but it has not been tested in larger studies.
Medical experts at China’s National Center for Cardiovascular Disease recently set up a study to determine whether taking tongxinluo along with STEMI guideline-directed treatments could improve outcomes in people with STEMI.
In their 12-month clinical trial of 3,777 people with STEMI, the team found that this therapy was associated with markedly reduced cardiac and cerebrovascular events.
The original research was published in October 2023 Jama,
China Tongxinluo Study for Myocardial Protection in Patients with Acute Myocardial Infarction (CTS-AMI) was a randomized clinical trial conducted in 124 clinical centers across China. There were 1,899 people in the Tongxinluo group, and 1,898 subjects in the placebo group, although some were ultimately excluded from the study.
To guide their research, the study authors asked: “In patients with acute ST-segment elevation myocardial infarction (STEMI), is there any benefit in incorporating a traditional Chinese medicine compound (tongxinluo) as an adjunctive treatment to guideline-directed therapies?” “Does it improve clinical outcomes?”
Researchers gave participants Tongxinluo orally via capsules for 12 months, and they gave a placebo to a control group.
Researchers evaluated the capsules for clinical effectiveness and safety at 30 days and one year. Both types of capsules were similar in appearance, smell and taste.
Both groups demonstrated similar patient baseline characteristics and care details. The average age of the participants was 61 years, and 77% were male.
The trial ran from May 2019 to December 2020.
Endpoints at 30 days included major adverse cardiovascular and cerebrovascular events (MACCEs), such as cardiovascular death, myocardial re-infarction, cerebral stroke, cardiogenic shock, and heart failure.
One-year endpoints included MACCE, hospitalization due to heart failure, in-stent thrombosis, major bleeding, and all-cause mortality.
The primary endpoint of 30-day major adverse cardiovascular and cerebrovascular events (MACCEs) declined significantly with Tongxinluo. Cardiovascular deaths also reduced.
Furthermore, these effects persisted for a full year with no significant change in major bleeding.
Traditional medicines, often made from plant and/or insect components, have enjoyed a reputation for improving health for thousands of years. Naturally derived formulas exhibit a broad spectrum of mechanisms that work through multiple pathways in the body.
Tongxinluo is made from powders and extracts of plant and insect products.
Experts aren’t sure how the compound’s mechanism promotes healing. However, clinical evidence suggests that the component PaeoniflorinGinsenoside RG1, and ginsenoside RB1 may support and improve cardiovascular function.
Paeoniflorin, derived from white peony root extract, is a primary active ingredient in traditional Chinese medicines. It has been used to treat cardiovascular conditions such as heart attack atherosclerosis,
ginsenoside contains active ingredients Panax ginseng, Studies suggest that this compound may help treat atherosclerosis by protecting vascular endothelial cells from oxidative stress.
Tongxinluo means “opening the network (luo) of the heart (xin).” It was approved in China angina pectoris (stable angina) and ischemic stroke in 1996.
STEMI is a major, life-threatening cardiovascular event affecting people worldwide. In America, there is an estimate 550,000 new cases and 200,000 recurring cases Happens every year.
mortality rate For people with this condition the decline is between 2.5% and 10% in 30 days.
Risk factors for its onset include hypertension, type 2 diabetes, dyslipidemia, smoking, and family history of coronary artery disease.
medical news today discussed this study with Dr. Tom Ingegnochief physician at Charm City Integrative Health in Baltimore, MD, who was not involved in the research.
Dr. Ingegno said tongxinluo can also mean “through the heart collateral.”
“Classically, these collaterals refer to smaller meridians that flow through the body. According to traditional East Asian concepts, disease occurs when there is no good quality qi (energy) or blood, or qi and blood become stagnant. In the case of this type of heart attack, the concept is that these collaterals around the heart become blocked with stagnant blood, causing a heart attack,” he further explained.
The doctor shared that the formula includes three different groups of ingredients: animals, aromatics, and ginseng.
Animals include wingless cockroaches, leeches and scorpions, the venom of some of which helps root out collaterals. Aromatics help relieve inflammation and get the blood flowing.
While many traditional Chinese medicine studies lacked large sample sizes or produced conflicting results, the authors of the current study say their work “contained all the key elements of randomized clinical trials, including randomization, Placebo control, blinding, predefined outcome measures were included. […]and the decision of the blinded clinical end point committee.”
Thus, they are confident that “the present study can serve as a model for future clinical trials to evaluate the safety and efficacy of traditional Chinese medicine.”
However, since all participants were Chinese, this may limit the study’s insights to other ethnic populations.
The study has some other limitations.
Although tongxinluo has shown health benefits, how it actually works is not yet understood.
Dr. Ingegno responded to this concern: “Many difficulties arise when studying Chinese herbs from a Western perspective. Chinese herbal formulas contain many therapeutic compounds, not just each herb. These individual components make it challenging to extract the active compounds. Combine this with the more than a dozen herbs in this formula, and chemical reactions are likely to alter some of these compounds and create new compounds.”
He said that, from a traditional Chinese perspective, this formulation “makes sense to help move blood trapped in the heart.” However, he acknowledges that “it is challenging to advise where research should look for these answers.”
Furthermore, although physicians were instructed to administer guideline-recommended treatments, they varied and were not used optimally.
Researchers also believe that patients may not adhere to therapy outside the trial setting.
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