Antiplatelet and myocardial protective effect of Shexiang Tongxin Dropping Pill in patients undergoing percutaneous coronary intervention:A randomized controlled trial  

作　　者：Yan-jun Lin Kun-li Jiao Bo Liu Lu Fang Shu Meng 

机构地区：[1]Department of Cardiology,Xinhua Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200092,China [2]Haematopoiesis and Leukocyte Biology Laboratory,Baker Heart and Diabetes Research Institute,Melbourne,VIC 3004,Australia

出　　处：《Journal of Integrative Medicine》2022年第2期126-134,共9页结合医学学报（英文版）

基　　金：supported by Science and Technology Commission of Shanghai Municipality(Grant No.16401972000);Shanghai Municipal Administration of Traditional Chinese Medicine(Grant No.ZY(2018-2020)-FWTX-3027)。

摘　　要：Background:High on-clopidogrel platelet reactivity could be partially explained by loss-of-function alleles of CYP2 C19,the enzyme that converts clopidogrel into its active form.Shexiang Tongxin Dropping Pill(STDP)is a traditional Chinese medicine to treat angina pectoris.STDP has been shown to improve blood flow in patients with slow coronary flow and attenuate atherosclerosis in apolipoprotein E-deficient mice.However,whether STDP can affect platelet function remains unknown.Objective:The purpose of this study is to examine the potential effects of STDP on platelet function in patients undergoing percutaneous coronary intervention(PCI)for unstable angina.The interaction between the effects of STDP with polymorphisms of CYP2 C19 was also investigated.Design,participants and intervention:This was a single-center,randomized controlled trial in patients undergoing elective PCI for unstable angina.Eligible subjects were randomized to receive STDP(210 mg per day)plus dual antiplatelet therapy(DAPT)with clopidogrel and aspirin or DAPT alone.Main outcome measures:The primary outcome was platelet function,reflected by adenosine diphosphate(ADP)-induced platelet aggregation and platelet microparticles(PMPs).The secondary outcomes were major adverse cardiovascular events(MACEs)including recurrent ischemia or myocardial infarction,repeat PCI and cardiac death;blood biomarkers for myocardial injury including creatine kinase-MB isoenzyme(CK-MB)and high-sensitive troponin I(hs Tn I);and biomarkers for inflammation including intercellular cell adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1),monocyte chemoattractant protein-1(MCP-1)and galectin-3.Results:A total of 118 subjects(mean age:[66.8±8.9]years;male:59.8%)were included into analysis:58 in the control group and 60 in the STDP group.CYP2 C19 genotype distribution was comparable between the 2 groups.In comparison to the control group,the STDP group had significantly lower CKMB(P<0.05)but similar hs Tn I(P>0.05)at 24 h after PCI,lower ICAM-1,VCAM-1,MC

关 键 词：Shexiang Tongxin Dropping Pill Traditional Chinese medicine Dual antiplatelet therapy CYP2C19 gene polymorphism Platelet reactivity 

分 类 号：R285.6[医药卫生—中药学]