ArticleChinese journal of integrative medicine2026
Tongxinluo Adjunctive Therapy and 12-Month Cardiovascular Outcomes after ST-Segment Elevation Myocardial Infarction: A Real-World Multicenter Prospective Cohort Study.
Article in Chinese journal of integrative medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo evaluate the efficacy and safety of Tongxinluo in improving medium- and long-term prognosis of patients with ST-segment elevation myocardial infarction (STEMI) in a real-world setting.
methodsThis multicenter prospective cohort study enrolled STEMI patients from 122 certified chest pain centers in China. Participants were stratified into exposure (n=1,598) and non-exposure (n=1,600) groups based on Tongxinluo administration initiation before or within 24 h post-reperfusion. Both groups received percutaneous coronary intervention (PCI) or thrombolysis with guideline-based therapy. The primary endpoint was incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) at 12 months. Secondary endpoints included the incidence of severe STEMI complications at 30 days; MACCEs at 30 days and 6 months; composite endpoint events at 6 and 12 months; and all-cause mortality at 30 days, 6 months, and 12 months.
resultsA total of 3,198 patients were included in the primary analysis. The primary endpoint, MACCEs incidence at 12 months, was significantly lower in the exposure group [40 (2.5%) vs. 106 (6.6%)], driven by reductions in cardiac death and stroke. In the secondary endpoint analysis, early risk reduction was pronounced at 30 days [MACCEs: 19 (1.2%) vs. 64 (4.0%)] and 6 months [MACCEs: 33 (2.1%) vs. 90 (5.6%)]. The exposure group exhibited 92% lower 30-day STEMI complications [16 (1.0%) vs. 210 (13.1%)], including reductions in cardiogenic shock, acute heart failure, mechanical complications, and malignant arrhythmias. Composite endpoint risks decreased by 65% at 6 months [36 (2.3%) vs. 104 (6.5%)] and 66% at 12 months [43 (2.7%) vs. 127 (7.9%)], with significant heart failure readmission reductions and 89% lower severe bleeding risk. More surprisingly, the risk of all-cause death at 30 days, 6 months, and 1 year was reduced by 71%, 61% and 59% in the exposure group.
conclusionsAdjunctive Tongxinluo therapy demonstrated significant improvement in 12-month cardiovascular outcomes with favorable safety profile, suggesting potential benefits of integrating traditional Chinese medicine with evidence-based STEMI management. (Registration No. ChiCTR100054466).
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