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Background: The Shexiang Baoxin Pill (MUSKARDIA) has been used for treating coronary artery disease (CAD) and angina for more than 30 years in China. Nevertheless, methodologically sound trials on the use of MUSKARDIA in CAD patients are scarce. The aim of the study is to determine the effects of MUSKARDIA as an add-on to optimal medical therapy (OMT) in patients with stable CAD., Methods: A total of 2674 participants with stable CAD from 97 hospitals in China were randomized 1:1 to a MUSKARDIA or placebo group for 24 months. Both groups received OMT according to local tertiary hospital protocols. The primary outcome was the occurrence of a major adverse cardiovascular event (MACE), defined as a composite of cardiovascular death, non-fatal myocardial infarction (MI), or non-fatal stroke. Secondary outcomes included all-cause mortality, non-fatal MI, non-fatal stroke, hospitalization for unstable angina or heart failure, peripheral revascularization, angina stability and angina frequency., Results: In all, 99.7% of the patients were treated with aspirin and 93.0% with statin. After 2 years of treatment, the occurrence of MACEs was reduced by 26.9% in the MUSKARDIA group (MUSKARDIA: 1.9% vs. placebo: 2.6%; odds ratio = 0.80; 95% confidence interval: 0.45-1.07; P  = 0.2869). Angina frequency was significantly reduced in the MUSKARDIA group at 18 months (P = 0.0362). Other secondary endpoints were similar between the two groups. The rates of adverse events were also similar between the two groups (MUSKARDIA: 17.7% vs. placebo: 17.4%, P = 0.8785)., Conclusions: As an add-on to OMT, MUSKARDIA is safe and significantly reduces angina frequency in patients with stable CAD. Moreover, the use of MUSKARDIA is associated with a trend toward reduced MACEs in patients with stable CAD. The results suggest that MUSKARDIA can be used to manage patients with CAD., Trial Registration: chictr.org.cn, No. ChiCTR-TRC-12003513., (Copyright © 2020 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license.)

Objective: To investigate the effects of Shexiang Baoxin Pill (SBP) in intervening atherosclerosis and myocardial infarction (AS-MI) in experimental animals, and inspect its influences on angiogenesis., Methods: Twenty male New-Zealand rabbits were made into AS-MI model, and randomly divided into 2 groups equally. Group A was fed with high-fat diet for control; Group B was fed with high-fat diet but intervened with SBP. The cardiac function and the positive area of plaque were determined. The CD34 positive response intensity at infarcted marginal zone and aorta vessel wall, and the capillary density of myocardium were measured by immunohistochemical staining. In addition, the protein expressions of vascular endothelial growth factor (VEGF) and vascular endothelial growth factor receptor-2 (VEGFR-2) were detected by Western blot., Results: Compared to Group A, the cardiac function was obviously improved (P<0.05) and the plaque positive area (%) was significantly decreased in Group B (45.82 +/- 3.68 vs 82.56 +/- 4.97, P<0.01). The CD34 positive response intensity and the capillary density as well as VEGF and VEGFR-2 expressions in infarcted marginal zone in Group A were higher than those in Group B (P<0.01); but these parameters at aorta vessel walls were lower in Group A than in Group B (P<0.01)., Conclusion: SBP could advance the angiogenesis in the marginal zone of infarction, improve heart function, and embarrass angiogenesis in atherosclerotic plaque.

Objective: To investigate the effect of rhodiola on expression of vascular endothelial growth factors receptors (VEGFR) in myocardium of rats after myocardial infarction., Methods: On the basis of successful establishment of myocardial infarction rat model, the experimental animals were divided into the model group, the rhodiola group, the positive control group and the sham-operated group, they were sacrificed after 6 weeks feeding. Their hearts were resected and embedded in paraffin to make sections with standard immunohistochemistry stain. Then the stained slices were analyzed in the IMS cell imagine analysis system using immunohistochemical quantitative analysis software. The field of vision of left ventricular myocardial tissue in three sites selected from the marginal area of infarction in each slice were determined, the mean value was then converted to positive area. Meanwhile, the mean optical density (OD) was calculated and the various expressions of VEGFR, i.e. Flt-1, KDR and angiopoietin receptor (Tie-2) were measured., Results: The expressions of Flt-1 and Tie-2 in myocardial tissue were significantly increased in the rhodiola treated group after treatment, showing significant difference as compared with those in the positive control group and the model group (P < 0.05). The expression of KDR in myocardium after rhodiola intervention was higher than that in the sham-operated and nonintervened group (P < 0.05), but insignificantly different to that in the positive control group and model group., Conclusion: Rhodiola could improve angiogenesis to ameliorate myocardial ischemia by regulating the expression of Flt-1 and Tie-2 in ischemic myocardium.

Objective: To study the effect of salvianolate on the migration of endothelial cells induced by monocytes., Methods: Transwell-boydom system was used to test the migration of endothelial cells induced by monocytes. Enzyme-linked immunosorbent assay (ELISA) and RT-polymerase chain reaction (RT-PCR) method were used to determine the effect of salvianolate on the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) and their mRNA of monocytes., Results: The migration of endothelial cells induced by monocytes was facilitated by salvianolate, compared with the control. After the monocytes were treated by salvianolate for 24 hours, the expression of mRNA of VEGF and bFGF was significantly up-regulated, and the expression of VEGF and bFGF was increased., Conclusion: The facilitation of salvianolate on the migration of endothelial cells induced by monocytes was observed. Salvianolate stimulates the expression of VEGF and bFGF and their mRNA of monocytes, and salvianolate may have the role of inducing migration of endothelial cells by working on these two factors.

16 and 22 patients with positive ventricular late potentials (LP) recorded on signal-averaged electrocardiograms (SAECG) were treated with lidocaine 100 mg iv. or Astragalus membranaceus 24 g iv. drip for 2 weeks respectively. As a result, the SAECGs of 2 (12.5%) and 3 (13.6%) of them normalized respectively. Compared with baseline, there were no significant changes in average HFQRSD, LAS and RMS 40 after treatment of lidocaine. HFQRSD and LAS were shortened significantly 115.9 +/- 29.9 vs 125.1 +/- 29.4 ms (P < 0.001); and 44.8 +/- 15.4 vs 52.8 +/- 15.4 ms (P < 0.001), and RMS 40 was enlarged 20.0 +/- 18.6 vs 12.8 +/- 19.0 microV (P < 0.05) only after treatment of Astragalus membranaceus. It is suggested that the duration of LP was shortened.