Chinese Herbal Cardiotonic Pill Stabilizes Vulnerable Plaques in Rabbits by Decreasing the Expression of Adhesion Molecules

Effect of Tongguan Capsules () on Restenosis after Coronary Stent Implantation: Study Protocol for A Randomized Controlled Trial

BACKGROUND

Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate.

OBJECTIVE

This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation.

METHODS

Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months.

CONCLUSION

This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407).

MicroRNA-1 and Circulating Microvesicles Mediate the Protective Effects of Dantonic in Acute Myocardial Infarction Rat Models

Aim: To investigate the protective effect of dantonic in ischemic myocardial damage by evaluating the expression of circulating microvesicles (MVs) and microRNA-1 (miR-1) in two animal models.

Methods: Two animal models of myocardial ischemia were established that were isoproterenol-induced myocardial ischemia (ISO-AMI) rat model and the acute myocardial infarction rat model induced by ligation of the left anterior descending coronary artery (LAD-AMI) of rat. To investigate the protective effect of dantonic, we observed the myocardial infarction size, creatine kinase (CK), lactate dehydrogenase (LDH), aspartate aminotransferase (AST) activities, cardiac troponin I (cTnI) level in serum, and the plasma levels of miR-1 and MVs.

Results: The results showed that pretreatment with dantonic significantly attenuated the LAD-AMI induced myocardial damage by decreasing the size of myocardial infarction, CK, LDH, AST activities, and cTnI level in serum. High dose dantonic treatment could significantly abrogate the increased plasma levels of miR-1 and MVs as compared to the LAD rat model. In addition, pretreatment with dantonic also showed a significant myocardial protective effect through reducing the expression levels of CK, LDH, and AST as compared to the ISO-AMI model. Whereas the cTnI level was no significant difference between model group and control group, suggesting that the model caused less myocardial damage. In the ISO-induced myocardial ischemia model, there is no significant difference between the model group with the control group of MVs and miR-1 levels. This may be that miR-1 is reported as a biomarker of acute myocardial infarction. The pathological changes of IOS-induced acute myocardial ischemia model are also different from those of acute myocardial infarction.

Conclusion: Dantonic showed the protective effect in these two ischemic myocardial injury rat models, whereas the circulating miR-1 and MVs levels were only ameliorated in the LAD rat model.

Salvia miltiorrhizaBurge (Danshen): a golden herbal medicine in cardiovascular therapeutics

Salvia miltiorrhiza Burge (Danshen) is an eminent medicinal herb that possesses broad cardiovascular and cerebrovascular protective actions and has been used in Asian countries for many centuries. Accumulating evidence suggests that Danshen and its components prevent vascular diseases, in particular, atherosclerosis and cardiac diseases, including myocardial infarction, myocardial ischemia/reperfusion injury, arrhythmia, cardiac hypertrophy and cardiac fibrosis. The published literature indicates that lipophilic constituents (tanshinone I, tanshinone IIa, tanshinone IIb, cryptotanshinone, dihydrotanshinone, etc) as well as hydrophilic constituents (danshensu, salvianolic acid A and B, protocatechuic aldehyde, etc) contribute to the cardiovascular protective actions of Danshen, suggesting a potential synergism among these constituents. Herein, we provide a systematic up-to-date review on the cardiovascular actions and therapeutic potential of major pharmacologically active constituents of Danshen. These bioactive compounds will serve as excellent drug candidates in small-molecule cardiovascular drug discovery. This article also provides a scientific rationale for understanding the traditional use of Danshen in cardiovascular therapeutics.