Chinese patent medicines for coronary microvascular disease: clinical evidence and potential mechanisms

Abstract

Coronary microvascular disease (CMVD) is a high risk factor for many cardiovascular events. Due to the limited understanding of its pathophysiological mechanism, modern medicine still lacks therapeutic drugs for CMVD. Existing clinical studies have shown that traditional Chinese medicine (TCM) can effectively improve the clinical symptoms and quality of life of CMVD patients. As an indispensable part of TCM, Chinese patent medicines (CPMs) are widely used in clinical practice. In the face of numerous oral CPMs for treatment of CMVD, how to choose a reasonable medication regimen is one of the important issues in clinic. Based on this, this paper reviewed the clinical efficacy and recommended level of 12 CPMs in the treatment of CMVD, which are recommended by expert consensus on diagnosis and treatment of coronary microvascular disease with integrated Chinese and Western medicine (WM). In addition, this study also systematically summarized the possible mechanisms of CPMs in the treatment of CMVD by protecting coronary microvascular endothelial cells, improving vascular endothelial function, inhibiting inflammation, reducing oxidative stress, promoting angiogenesis, and improving hemorheology, aiming to provide meaningful information for its clinical application.

Comprehensive effect of Naoxintong capsule combined with Western medicine on coronary heart disease after percutaneous coronary intervention: a meta-analysis

“…Notably, oxidative stress reaction represents the key pathological mechanism underlying CHD, facilitating the development of atherosclerosis ( D'Oria et al, 2020 ). Lactoperoxidase (LPO) and myeloperoxidase (MPO) serve as reliable markers for lipid peroxidation; elevated LPO levels can exacerbate myocardial injury ( Chen et al, 2021 ), whereas MPO contributes to the generation of reactive oxygen species ( Yang et al, 2023 ). NXT effectively inhibits adhesion molecules and delays the progression of atherosclerosis by reducing MPO and LPO levels and enhancing oxidative stress conditions ( Yang et al, 2023 ).…”

“…Lactoperoxidase (LPO) and myeloperoxidase (MPO) serve as reliable markers for lipid peroxidation; elevated LPO levels can exacerbate myocardial injury ( Chen et al, 2021 ), whereas MPO contributes to the generation of reactive oxygen species ( Yang et al, 2023 ). NXT effectively inhibits adhesion molecules and delays the progression of atherosclerosis by reducing MPO and LPO levels and enhancing oxidative stress conditions ( Yang et al, 2023 ). This may be related to our findings suggesting that NXT improves clinical efficacy and increases the rate of ECG and angina improvement.…”

Unveiling the Enigma: Exploring the Intricate Link Between Coronary Microvascular Dysfunction and Takotsubo Cardiomyopathy

“…Understanding this association could offer insights into the triggers and pathogenesis of TCM. Furthermore, discerning the relationship between CMD and TCM stands to shape therapeutic strategies and enhance patient outcomes [ 8 , 9 ].…”