Tongxinluo (TXL), a traditional Chinese medicine approved to treat angina and stroke in China, significantly improved both the 30-day and one-year clinical outcomes of Chinese patients with STEMI, according to findings from the CTS-AMI trial presented Nov. 6 during AHA 2022 in Chicago.

The proof-of-concept trial randomized 3,777 patients with STEMI undergoing primary PCI at 124 hospitals in China to either TXL or placebo. The primary endpoint was 30-day major adverse cardiac events, a composite of cardiac death, emergent coronary revascularization, re-myocardial infarction (MI) and stroke.

Overall results found the primary endpoint occurred in 64 patients (3.39%) in the TXL group compared with 99 patients (5.24%) in the placebo group. In terms of secondary endpoints, 30-day cardiac death occurred in 56 (2.97%) of those in the TXL group vs. 80 (4.24%) in the placebo group, while 30-day MI did not occur with any patients in the TXL group compared with nine in the placebo group. Additionally, 30-day stroke occurred in four patients in the TXL group and nine in the placebo group, while no 30-day emergent coronary revascularization events were reported in either group.

Researchers also noted that TXL did not result in severe side effects such as major bleeding. No major differences in any select adverse events of interest were observed between the two groups, with the exception of renal injury in which a slightly larger benefit was observed with TXL compared with placebo.

"These findings support the use of TXL, as an adjunct therapy, in treating STEMI, at least in China and other developing countries," said Yuejin Yang MD, PhD, who presented the findings. He noted that "despite reperfusion and optimal medical therapy, patients with STEMI still face high risk of in-hospital mortality, myocardial no-flow and reperfusion injury, which have no targeted drugs so far worldwide."

Clinical Topics: Diabetes and Cardiometabolic Disease, Heart Failure and Cardiomyopathies, Prevention, Pulmonary Hypertension and Venous Thromboembolism, Vascular Medicine, Pulmonary Hypertension, Hypertension

Keywords: AHA Annual Scientific Sessions, AHA22, Myocardial Infarction, Medicine, Chinese Traditional, ACC International, Hypertension, Pulmonary

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