Effects of remote ischemic preconditioning combined with radix salviae decoction on coronary stenosis and prognosis

Background and objectives

Coronary stenosis is responsible for angina attacks in coronary heart disease (CHD). A prospective pilot study was conducted to investigate the effects of combining remote ischemic preconditioning (RIPC) with Radix salviae decoction (RSD).

Methods

A total of 60 patients diagnosed with CHD were enrolled and divided into the control group and the RIPC-RSD treatment group. The primary outcome was the frequency of angina attacks, while the secondary outcomes included Canadian Cardiovascular Society levels, emergency medications, and prognosis indicators.

Results

A total of 57 patients were included in the final analysis. Demographic characteristics and vessel stenosis comparisons showed similar results (p > 0.05). There was no significant difference in the frequency of angina attacks before (χ2 = 2.170, p = 0.404) or after (χ2 = 1.509, p = 0.662) treatment. Similarly, there was no significant difference in CCS levels of angina attacks between the two groups before (χ2 = 1.504, p = 0.681) or after (χ2 = 1.392, p = 0.707) treatment. Although there was no significant difference in the use of emergency medications for angina attacks before (χ2 = 1.321, p = 0.517) or after (χ2 = 2.457, p = 0.356) treatment, a significant decrease in the frequency of emergency medications was observed (Z = −2.188, p = 0.029). However, the RIPC-RSD treatment did not have a significant impact on the prognosis (cardiac death, χ2 = 1.831, p = 0.176; target vessel revascularization, χ2 = 1.111, p = 0.292; rehospitalization, χ2 = 0.495, p = 0.482) of coronary stenosis in CHD patients.

Conclusions

Owing to a small sample size, we did not observe significant effects of RIPC-RSD on angina attacks and prognosis in patients with CHD. However, it may be effective in reducing the frequency of emergency medication use. Several factors may contribute to these findings. Firstly, the small sample size may not adequately represent the entire population, leading to potential individual variations and sampling errors. Secondly, the intervention of RIPC could be optimized, including the duration of treatment, early initiation in the target population, treatment dosing, and evaluation of biomarkers. These factors may influence the clinical benefits for patients. Thirdly, this prospective pilot study provides valuable information, particularly in terms of sample size estimation, to guide the design of future randomized controlled trials or real-world studies evaluating the combined effect of RIPC-RSD in CHD treatment. Therefore, in future studies, we will increase the sample size, improve the design of clinical trials, optimize the intervention of RIPC, select a more suitable patient population, and employ appropriate statistical analysis methods based on the collected clinical data to enhance the quality of the study.

https://www.xiahepublishing.com/2835-6357/FIM-2023-00034

The study was recently published in the Future Integrative Medicine.

Future Integrative Medicine (FIM) publishes both basic and clinical research, including but not limited to randomized controlled trials, intervention studies, cohort studies, observational studies, qualitative and mixed method studies, animal studies, and systematic reviews.

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