Abstract
Objective
To explore the effect of Shenmai Injection (SMI) on the long-term prognosis of patients with chronic heart failure (CHF).
Methods
The Hospital Information System was used to extract data of CHF patients, and the retrospective cohort study was conducted for analysis. In non-exposed group, standardized Western medicine treatment and Chinese patent medicine or decoction were applied without combination of SMI while in the exposed group, SMI were applied for more than 7 days. Evaluation indicators are followed with New York Heart Association functional classification (NYHA classification), left ventricular ejection fraction (LVEF), N-terminal brain natriuretic peptide precursor (NT-ProBNP), cardiogenic death and heart failure (HF) readmission. Statistical analysis includes Kaplan-Meier analysis and Cox regression which are used to explore the relationship between SMI and outcome events.
Results
A total of 1,211 eligible CHF patients were involved and finally 1,047 patients were followed up successfully. After treatment, the cases of NYHA classification decline in the exposed and non-exposed groups accounted for 64.30% and 43.45%, respectively; the improvement values of LVEF were 8.89% and 7.91%, respectively; the improvement values of NT-ProBNP were 909 pg/mL and 735 pg/mL, respectively. After exposure on SMI, the rates of cardiogenic death and HF readmission reduced from 15.43% to 10.18% and 38.93% to 32.37%. According to Kaplan-Meier analysis, the log-rank P value of SMI and cardiogenic death was 0.014, while the counterpart of SMI and HF readmission was 0.025. Cox regression analysis indicated that for cardiogenic death, age, cardiomyopathy, diabetes, and NYHA classification were risk factors while β-blockers, aldosterone receptor antagonists, Chinese patent medicine/decoction and SMI were protective factors. Likewise, for HF readmission, age, cardiomyopathy, and NYHA classification were risk factors while SMI was a protective factor.
Conclusion
Combination with SMI on the standardized Western medicine treatment can effectively reduce cardiogenic mortality and readmission rate in CHF patients, and thereby improve the long-term prognosis.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Hu SS, Gao RL, Liu LS, Zhu ML, Wang W, Wang YJ, et al. Summary of “Chinese Cardiovascular Disease Report 2018”. Chin Circ (Chin) 2019;34:209–220.
Sun RH, Shan QJ. Current status and prospects of heart failure readmission. Med Recapitulate (Chin) 2014;20:2757–2760.
Al-Omary MS, Davies AJ, Evans TJ, Bastian B, Fletcher PJ, Attia J, et al. Mortality and readmission following hospitalisation for heart failure in Australia: a systematic review and meta-analysis. Heart Lung Circ 2018;27:917–927.
Gao WL. Cohort research method and key technologies of clinical efficacy evaluation of traditional Chinese medicine [dissertation]. Jinan: Shandong University of Traditional Chinese Medicine; 2019.
Dai GH, Guan H, Gao WL. Investigation and analysis of the application of traditional Chinese medicine during the hospitalization of 2,700 patients with chronic heart failure in traditional Chinese medicine hospital. http://jsp.365heart.com/detail/article/97C2BC68-26DA-42B7-BDE3-C64C7BE67100.
Li XL, Shen Y, He F, Li F, Zhu YC. Effectiveness and safety of Shenmai injection in treatment of shock: A meta-analysis. J Tradit Chin Med 2018;38:155–166.
Zhou YS, Zhao BM, Wu WY, Yang XB, Long SQ, Deng H, et al. Shenmai Injection for the treatment of cancer-related fatigue in advanced non-small cell lung cancer patients undergoing chemotherapy: study protocol for a randomized controlled trial. Trials 2018;19:474.
Chen L, Wang LR, Zhuo Q, Zhang Q, Chen FF, Li LL, et al. Effect of Shenmai injection on cognitive function after cardiopulmonary bypass in cardiac surgical patients: a randomized controlled trial. BMC Anesthesiol 2018;18:142.
Chen HD, Xie YM, Wang LX, Wu JB. Systematic review of efficacy and safety of shenmai injection for chronic heart failure. China J Chin Mater Med (Chin) 2014;39:3650–3661.
Cardiovascular Branch of Chinese Medical Association, Editorial Board of Chinese Journal of Cardiovascular Diseases. Guidelines for Diagnosis and Treatment of Chinese Heart Failure 2014. Chin J Cardiovasc Med (Chin) 2014;42:3–10.
Mei YR. A retrospective study on the effect of traditional Chinese medicine on mortality of patients with chronic heart failure [dissertation]. Beijing: Beijing University of Traditional Chinese Medicine; 2015.
Hou XM. Statistical methods in a cohort study of clinical efficacy evaluation of traditional Chinese medicine and their application in chronic heart failure [dissertation]. Shandong: Shandong University of Traditional Chinese Medicine; 2020.
Kevin SS, Xu HL, Roland AM, Deepak LB, Paul AH, Adrian FH, et al. Heart failure with preserved, borderline, and reduced ejection fraction: 5-year outcomes. J Am Coll Cardiol 2017;70:2476–2486.
Ge WJ. The clinical value of Shenmai Injection in the treatment of refractory heart failure. Electronic J Clin Med Literature (Chin) 2017;4:12211.
Wang Q, Wu Y, Zhang HZ. Observation on the curative effect of Shenmai injection on 35 cases of chronic heart failure. Zhejiang J Tradit Chin Med (Chin) 2017;52:923–924.
Ma RG, Wang CX, Shen YH, Wang ZQ, Ma JH, Huang LS. Effect of Shenmai Injection on ventricular diastolic function in patients with chronic heart failure: an assessment by tissue Doppler imaging. Chin J Integr Med 2010;16:173–175.
Long MZ, Wang DB, Yang JM, Zhou LY. Clinical study on effect of Shenmai Injection in treating congestive heart failure. Chin J Integr Med 2004;1:62.
Wei X, Xie TM, Tian F, Shen H, Jiang JJ, Sun SL, et al. Thoughts and methods of constructing chronic disease risk prediction model combining disease and syndrome. J Basic Chin Med (Chin) 2017;23:798–801.
Yu XN, Feng XG, Zhang JM, Huang JJ, Zhang Q. New progress in the research on the chemical constituents and pharmacological effects of ginseng. Ginseng Res (Chin) 2019;31:47–51.
Zhang J. Research progress of the pharmacological effects of ginsenosides in the cardiovascular system. Clin J Chin Med (Chin) 2019;11:141–144.
Ding DZ, Shen TK, Cui YZ, Li XN, Jin HM, Jin CY, et al. Study on curative effect and mechanism of red ginseng on congestive heart failure. Chin J Integr Med 1995;6:325–327.
Fan S, Zhang J, Xiao Q, Liu P, Zhang Y, Yao E, et al. Cardioprotective effect of the polysaccharide from Ophiopogon japonicus on isoproterenol-induced myocardial ischemia in rats. Int J Biol Macromol 2020;147:233–240.
Zhao Y, Zhang F, Zhao XP, Yuan W, Zhang JH, Wang Y. Shenmai Injection protects mitochondria from oxidative injury in myocardial cells and its mechanism. J Zhejiang Univ (Chin) 2018;47:507–513.
Xuan JJ, Gao CX, Guan HM, Jie JH, Chen YS, Luo MH, et al. Long-term clinical efficacy of Shenmai Injection in patients with heart failure after acute myocardial infarction. Chin Patent Med (Chin) 2015;37:465–467.
Author information
Authors and Affiliations
Contributions
This project was initiated and developed by Dai GH and Guan H. Dai GH, Guan H were involved in the design of the study. Guan H, Gao WL were involved in drafting and writing the manuscript. Sun C, Liu Z were involved in the extraction of data. Ren LL, Hou XM were involved in the follow-up of the patients. Guan H was involved in the statistical analysis of data. Zhang T was involved in data checking. All authors read and approved the final manuscripts.
Corresponding author
Ethics declarations
The authors report no conflict of interest.
Additional information
Supported by National Key R&D Program of China (No. 2019YFC1710400 and No. 2019YFC1710401) and National Natural Science Foundation of China (No. 81774047)
Electronic supplementary material
Rights and permissions
About this article
Cite this article
Guan, H., Dai, Gh., Gao, Wl. et al. Effect of Shenmai Injection on Long-Term Prognosis of Patients with Chronic Heart Failure: A Multicenter, Large Sample Capacity, Long-Term Follow-Up Retrospective Cohort Study. Chin. J. Integr. Med. 28, 312–318 (2022). https://doi.org/10.1007/s11655-021-2875-y
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11655-021-2875-y