PMID- 32940893 OWN - NLM STAT- MEDLINE DCOM- 20211213 LR - 20211214 IS - 1573-7241 (Electronic) IS - 0920-3206 (Linking) VI - 35 IP - 2 DP - 2021 Apr TI - Efficacy of Sodium Tanshinone IIA Sulfonate in Patients with Non-ST Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention: Results from a Multicentre, Controlled, Randomized Trial. PG - 321-329 LID - 10.1007/s10557-020-07077-8 [doi] AB - BACKGROUND: Sodium tanshinone IIA sulfonate (STS) has been widely used by Chinese medicine practitioners for chronic cardiovascular diseases. However, its direct clinical efficacy in patients with acute coronary syndrome following percutaneous coronary intervention (PCI) has not been reported yet. The present trial aimed to investigate potential cardioprotection of STS in patients undergoing PCI for non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: In a randomized, double-blind, placebo-controlled trial, 372 patients with NSTE-ACS were randomly assigned to receive STS (n = 192) or saline (n = 180) for 2 days before and 3 days after PCI along with standard therapy. The primary endpoint was the composite incidence of major adverse cardiac events (MACEs), including death, non-fatal myocardial infarction, repeated revascularization of the target vessel, and stent thrombosis, within 30 days after PCI. RESULTS: The 30-day MACEs occurred in 18.8% of the patients in the STS group and in 27.2% of the patients in the control group (P = 0.038); this difference was mostly driven by reduction of myocardial infarction incidence (17.2% vs. 26.7%, P = 0.027). Post-procedural elevation of troponin-I was also significantly lower in the STS group (26.56% vs. 47.78%, P < 0.001). Multivariable analysis identified STS as a predictor of decreased risk of MACE occurrence (odds ratio: 0.60, 95% confidence interval: 0.36 to 0.99; P = 0.045). CONCLUSION: Addition of STS to the standard treatments recommended by the current practice guidelines in patients with NSTE-ACS undergoing PCI could reduce myocardial injury and the occurrence of short-term cardiovascular events, primarily driven by non-fatal myocardial infarction. TRIAL REGISTRATION: ChiCTR-TRC-14005182. FAU - Mao, Shuai AU - Mao S AD - Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - AMI Key lab of Chinese Medicine in Guangzhou, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Wang, Lei AU - Wang L AD - Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - AMI Key lab of Chinese Medicine in Guangzhou, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Zhao, Xujie AU - Zhao X AD - Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - AMI Key lab of Chinese Medicine in Guangzhou, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Guo, Liheng AU - Guo L AD - Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. AD - AMI Key lab of Chinese Medicine in Guangzhou, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. FAU - Lin, Qian AU - Lin Q AD - Dongfang Hospital of Beijing University of Chinese Medicine, Beijing, China. FAU - Wang, Xiaofeng AU - Wang X AD - Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China. FAU - Dai, Xiaohua AU - Dai X AD - First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China. FAU - Shang, Hongcai AU - Shang H AD - Key Laboratory of Chinese Internal Medicine of ME and Beijing, Beijing University of Chinese Medicine, Beijing, China. FAU - Zhang, Minzhou AU - Zhang M AD - Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou, China. minzhouzhang@aliyun.com. AD - AMI Key lab of Chinese Medicine in Guangzhou, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China. minzhouzhang@aliyun.com. AD - 2nd Affiliated Hospital of Guangzhou University of Chinese Medicine, Yuexiu District, Guangzhou, 510120, China. minzhouzhang@aliyun.com. FAU - Hinek, Aleksander AU - Hinek A AD - Translational Medicine, Hospital for Sick Children, University of Toronto, Toronto, Canada. LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial DEP - 20200915 PL - United States TA - Cardiovasc Drugs Ther JT - Cardiovascular drugs and therapy JID - 8712220 RN - 0 (Cardiovascular Agents) RN - 0 (Phenanthrenes) RN - 69659-80-9 (tanshinone II A sodium sulfonate) SB - IM MH - Acute Coronary Syndrome/classification/mortality/*surgery MH - Aged MH - Cardiovascular Agents/adverse effects/*therapeutic use MH - Cardiovascular Diseases/epidemiology MH - Comorbidity MH - Double-Blind Method MH - Female MH - Humans MH - Male MH - Middle Aged MH - Percutaneous Coronary Intervention/*methods MH - Phenanthrenes/adverse effects/*therapeutic use OTO - NOTNLM OT - Non-ST segment elevation acute coronary syndrome OT - Percutaneous coronary intervention OT - Periprocedural myocardial infarction OT - Sodium tanshinone IIA sulfonate EDAT- 2020/09/18 06:00 MHDA- 2021/12/15 06:00 CRDT- 2020/09/17 12:18 PHST- 2020/09/10 00:00 [accepted] PHST- 2020/09/18 06:00 [pubmed] PHST- 2021/12/15 06:00 [medline] PHST- 2020/09/17 12:18 [entrez] AID - 10.1007/s10557-020-07077-8 [pii] AID - 10.1007/s10557-020-07077-8 [doi] PST - ppublish SO - Cardiovasc Drugs Ther. 2021 Apr;35(2):321-329. doi: 10.1007/s10557-020-07077-8. Epub 2020 Sep 15.