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A randomized controlled trial was conducted to evaluate the efficacy and safety of Yangxinshi tablets in improving the condition of patients with coronary heart disease complicated by cardiac dysfunction.
The purpose of this study was to investigate whether the addition of Yangxinshi tablets to conventional treatment can reduce the composite endpoint time, increase exercise tolerance, and improve quality of life and mental health in patients with coronary heart disease complicated by cardiac dysfunction. A total of 2708 eligible patients were randomly divided into two groups. In addition to conventional treatment, the trial group was given Yangxinshi tablets (3 tablets/time, 3 times/day), while the control group was a blank control. The treatment cycle continued until the expected number of endpoint events was reached or the study ended, whichever occurred first. The primary endpoint was the composite endpoint of ischemic events or heart failure-related clinical events (including all-cause death, ischemia-driven revascularization, stroke, myocardial infarction (MI), and readmission due to aggravated ACS or heart failure) during the study period.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Trial group | Experimental | Basic treatment and Trial drug |
|
| Control group | Sham Comparator | Basic treatment |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Yangxinshi tablet | Drug | Basic treatment: All patients received a conventional treatment regimen, including outcome-improving drugs (aspirin, P2Y12 receptor inhibitor、β-blockers, statins, ARNI /ACEI/ARB, SGLT2i, and MRA) and symptom-relieving drugs (nitrates, calcium antagonists, and loop diuretic). Trial drug: Yangxinshi tablets, 3 tablets/3 times a day, taken orally |
| Measure | Description | Time Frame |
|---|---|---|
| The composite endpoint was ischemic events or heart failure-related clinical events | All-cause death, ischemia-driven revascularization, stroke, MI, and readmission due to aggravated ACS or heart failure | Through study completion, an average of 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Ischemic composite endpoint events | Cardiovascular and cerebrovascular death, MI, ischemia-driven revascularization, stroke, and readmission due to ACS | Through study completion, an average of 3 years |
| Heart failure-related clinical events |
| Measure | Description | Time Frame |
|---|---|---|
| Heart rate | Unit: beats /minute | After 24 and 48 weeks of treatment |
| Blood pressure | Systolic and diastolic,unit: mmHg | After 24 and 48 weeks of treatment |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Han ya ling | Contact | 024-28856114 | hanyaling@263.net |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The People's Hospital of Bozhou | Not yet recruiting | Haozhou | Anhui | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39210710 | Result | Vrints C, Andreotti F, Koskinas KC, Rossello X, Adamo M, Ainslie J, Banning AP, Budaj A, Buechel RR, Chiariello GA, Chieffo A, Christodorescu RM, Deaton C, Doenst T, Jones HW, Kunadian V, Mehilli J, Milojevic M, Piek JJ, Pugliese F, Rubboli A, Semb AG, Senior R, Ten Berg JM, Van Belle E, Van Craenenbroeck EM, Vidal-Perez R, Winther S; ESC Scientific Document Group. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Sep 29;45(36):3415-3537. doi: 10.1093/eurheartj/ehae177. No abstract available. | |
| 39566404 |
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|
| Blank control | Drug | Basic treatment: All patients received a conventional treatment regimen, including outcome-improving drugs (aspirin, P2Y12 receptor inhibitor、β-blockers, statins, ARNI /ACEI/ARB, SGLT2i, and MRA) and symptom-relieving drugs (nitrates, calcium antagonists, and loop diuretic). Trial drug: Blank control |
|
Readmission due to aggravated heart failure or all-cause death
| Through study completion, an average of 3 years |
| Cardiovascular and cerebrovascular deaths | Occurrence of cardiovascular and cerebrovascular deaths | Through study completion, an average of 3 years |
| All-cause death | Occurrence of all-cause death | Through study completion, an average of 3 years |
| Readmission due to ACS | Readmission due to ACS | Through study completion, an average of 3 years |
| Readmission due to aggravated heart failure | Readmission due to aggravated heart failure | Through study completion, an average of 3 years |
| The cumulative incidence of readmission due to aggravated ACS or heart failure | The joint gamma frailty model was adopted for analysis | Through study completion, an average of 3 years |
| Win ratio | The main efficacy indicators were analyzed by using the win ratio method | Through study completion, an average of 3 years |
| 6MWD | Change in 6-minute walking distance | From baseline at 48 weeks |
| NT-proBNP or BNP | Measurement of NT-proBNP or BNP, calculation of the proportion of patients achieving NT-proBNP <125 pg/mL (or BNP <35 pg/mL), and the degree of reduction | From baseline at 48 weeks |
| Patient Health Questionnaire - 9(PHQ-9) depression scale | The Patient Health Questionnaire - 9(PHQ-9)depression scale comprises nine questions. In each assessment area, scores range from 0 to 3 based on the increasing frequency of difficult: 0 indicates "not at all," 1 indicates "sometimes," 2 indicates "more than half the time," and 3 indicates "almost every day." The total score ranges from 0 to 27,higher scores mean a worse outcome. | After 24 and 48 weeks of treatment |
| Generalized Anxiety Disorder 7 - item Scale(GAD-7) anxiety scale | The Generalized Anxiety Disorder 7 - item Scale(GAD-7) anxiety scale comprises seven questions. In each assessment area, scores range from 0 to 3 based on the increasing frequency of difficult: 0 indicates "not at all," 1 indicates "sometimes," 2 indicates "more than half the time," and 3 indicates "almost every day." The total score ranges from 0 to 21,higher scores mean a worse outcome. | After 24 and 48 weeks of treatment |
| NYHA | Changes in New York Heart Association (NYHA) functional classification | After 24 and 48 weeks of treatment |
| SAQ | Changes in Seattle Angina Questionnaire (SAQ) scores.The SAQ scale is divided into 5 dimensions, with a total of 19 items, and each item is scored out of 100 points. The higher the score, the better the therapeutic effect | After 24 and 48 weeks of treatment |
| KCCQ-OS | Changes in Kansas City Cardiomyopathy Questionnaire overall score (KCCQ-OS) compared to baseline.The total score ranges from 0 to 100,higher scores mean a better outcome. | After 24 and 48 weeks of treatment |
| Echocardiography | Changes from baseline examined via echocardiography, including left ventricular systolic function (left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVSd), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (FS) and left ventricular diastolic function (E/A and E/e) . When possible, the left ventricular global longitudinal strain rate (LVGLS) was also measured | After 48 weeks of treatment |
| Metabolic equivalents(METs) | Changes in metabolic equivalents(METs) determined by cardiopulmonary exercise testing in some patients. | After 48 weeks of treatment |
| Anaerobic thresholds (ATs) | Changes in anaerobic thresholds (ATs) determined by cardiopulmonary exercise testing in some patients. | After 48 weeks of treatment |
| Maximal oxygen consumption (VO2max) | Changes in maximal oxygen consumption (VO2max) determined by cardiopulmonary exercise testing in some patients. | After 48 weeks of treatment |
| VO2/heart rate(HR) | Changes in VO2/HR determined by cardiopulmonary exercise testing in some patients. | After 48 weeks of treatment |
| The ratio of the change in VO2 to the change in the work rate (△VO2/△WR) | Changes in △VO2/△WR determined by cardiopulmonary exercise testing in some patients. | After 48 weeks of treatment |
| 12-lead Electrocardiogram (ECG) | 12-lead ECG consists of Ⅰ、Ⅱ、Ⅲ、aVR、aVL、aVF、V1、V2、V3、V4、V5、V6.ECG consists of P wave, PR interval, QRS complex, ST segment, and T wave. | After 24 and 48 weeks of treatment |
| White blood cell (WBC) count | Normal value: 4-10, unit: 109/L.Check at 24 and 48 weeks to see if it is within the normal range. | After 24 and 48 weeks of treatment |
| Red blood cell (RBC) count | Normal value: 3.5-5, unit: 1012/L.Check at 24 and 48 weeks to see if it is within the normal range. | After 24 and 48 weeks of treatment |
| Hemoglobin (Hb) level | Normal value: 110-150, unit: g/L.Check at 24 and 48 weeks to see if it is within the normal range. | After 24 and 48 weeks of treatment |
| Platelet (PLT) count | Normal value: 100-300,unit: 109/L.Check at 24 and 48 weeks to see if it is within the normal range. | After 24 and 48 weeks of treatment |
| Liver function test | Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) | After 24 and 48 weeks of treatment |
| Serum creatinine concentration | Unit: μmol /L | After 24 and 48 weeks of treatment |
| Estimated glomerular filtration rate (eGFR) | Unit: ml/minute.Calculated using the Modification of Diet in Renal Disease (MDRD) equation | After 24 and 48 weeks of treatment |
| Adverse events | Adverse events/serious adverse events | Through study completion, an average of 3 years |
| Beijing Hospital of Traditional Chinese Medicine | Not yet recruiting | Beijing | Beijing Municipality | China |
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| Dongfang Hospital,Beijing University of Chinese Medicine | Not yet recruiting | Beijing | Beijing Municipality | China |
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| Guang'anmen Hospital,China Academy of Chinese Medical Sciences | Not yet recruiting | Beijing | Beijing Municipality | China |
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| Army Specialty Medical Center | Not yet recruiting | Chongqing | Chongqing Municipality | China |
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| Chongqing Emergency Medical Center | Not yet recruiting | Chongqing | Chongqing Municipality | China |
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| Chongqing General Hospital | Not yet recruiting | Chongqing | Chongqing Municipality | China |
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| Chongqing University Three Gorges Hospital | Not yet recruiting | Chongqing | Chongqing Municipality | China |
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| The Southwest Hospital of Amu | Not yet recruiting | Chongqing | Chongqing Municipality | China |
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| The First Hospital of Lanzhou University | Not yet recruiting | Lanzhou | Gansu | China |
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| The affiliated traditional Chinese medicine hospital of Guangzhou Medical University | Not yet recruiting | Guangzhou | Guangdong | China |
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| The first affiliated hospital, Sun Yat-sen University | Not yet recruiting | Guangzhou | Guangdong | China |
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| The Second Affiliated Hospital of Shantou University Medical College | Not yet recruiting | Shantou | Guangdong | China |
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| The Fifth Affiliated Hospital,Sun Yat-sen University | Not yet recruiting | Zhuhai | Guangdong | China |
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| The First Affiliated Hospital of Guilin Medical University | Not yet recruiting | Guilin | Guangxi | China |
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| Liuzhou People's Hospital | Not yet recruiting | Liuzhou | Guangxi | China |
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| The First Affiliated Hospital of Guangxi Medical University | Not yet recruiting | Nanning | Guangxi | China |
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| The People's Hospital of Guangxi Zhuang Autonomous Region | Not yet recruiting | Nanning | Guangxi | China |
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| The First Affiliated Hospital of Guizhou Medical University | Not yet recruiting | Guiyang | Guizhou | China |
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| The First Affiliated Hospital of Zunyi Medical University" | Not yet recruiting | Zunyi | Guizhou | China |
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| Baoding No.1 Central Hospital | Not yet recruiting | Baoding | Hebei | China |
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| Jingjiang People's Hospital | Not yet recruiting | Cangzhou | Hebei | China |
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| Handan Central Hospital | Not yet recruiting | Handan | Hebei | China |
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| Hebei General Hospital | Not yet recruiting | Shijiazhuang | Hebei | China |
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| Xingtai People's Hospital | Not yet recruiting | Xingtai | Hebei | China |
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| The First Affiliated Hospital of Hebei North University | Not yet recruiting | Zhangjiakou | Hebei | China |
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| Daqing Oilfield General Hospital | Not yet recruiting | Daqing | Heilongjiang | China |
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| The First Affiliated Hospital of Harbin Medical University | Not yet recruiting | Haerbin | Heilongjiang | China |
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| The Second Affiliated Hospital of Harbin Medical University | Not yet recruiting | Haerbin | Heilongjiang | China |
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| HeGang People's Hospital | Not yet recruiting | Hegang | Heilongjiang | China |
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| Mudanjiang Cardiovascular Disease Hospital | Not yet recruiting | Mudanjiang | Heilongjiang | China |
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| The 7th People's Hospital of Zhengzhou | Not yet recruiting | Zhengzhou | Henan | China |
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| The Third People's Hospital of Zhengzhou | Not yet recruiting | Zhengzhou | Henan | China |
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| Hunan Provincial TCM Hospital | Not yet recruiting | Changsha | Hunan | China |
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| Yiyang Central Hospital | Not yet recruiting | Yiyang | Hunan | China |
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| Xuyi People's Hospital | Not yet recruiting | Huai'an | Jiangsu | China |
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| Nanjing Lishui People's Hospital | Not yet recruiting | Nanjing | Jiangsu | China |
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| Zhongda Hospital Southeast University | Not yet recruiting | Nanjing | Jiangsu | China |
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| Jiangsu Provincial People's Hospital Suqian Branch | Not yet recruiting | Suqian | Jiangsu | China |
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| Taizhou Fourth People's Hospital | Not yet recruiting | Taizhou | Jiangsu | China |
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| Xuzhou No.1 People's Hospital | Not yet recruiting | Xuzhou | Jiangsu | China |
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| Affiliated Hospital of Changchun University of Traditional Chinese Medicine | Not yet recruiting | Changchun | Jilin | China |
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| Jilin Provincial People's Hospital | Not yet recruiting | Changchun | Jilin | China |
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| The First Bethune Hospital of Jilin University | Not yet recruiting | Changchun | Jilin | China |
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| The Second Norman Bethune Hospital of Jilin University | Not yet recruiting | Changchun | Jilin | China |
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| Jilin People's Hospital | Not yet recruiting | Jilin City | Jilin | China |
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| The First Affiliated Hospital of Dalian Medical University | Not yet recruiting | Dalian | Liaoning | China |
| Dandong Central Hospital | Not yet recruiting | Dandong | Liaoning | China |
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| Fushun Central Hospital | Not yet recruiting | Fushun | Liaoning | China |
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| Fuxin Central Hospital | Not yet recruiting | Fuxin | Liaoning | China |
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| General Hospital of Northern Theater Command | Recruiting | Shenyang | Liaoning | 110016 | China |
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| The First Hospital of China Medical University | Not yet recruiting | Shenyang | Liaoning | China |
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| The Fourth Affiliated Hospital of China Medical University | Not yet recruiting | Shenyang | Liaoning | China |
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| Chifeng Municipal Hospital | Not yet recruiting | Chifeng | Neimenggu | China |
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| General Hospital of Ningxia Medical University | Not yet recruiting | Yinchuan | Ningxia | China |
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| Qilu Hospital of Shandong University | Not yet recruiting | Jinan | Shandong | China |
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| Shandong University of Traditional Chinese Medicine Affiliated Hospital | Not yet recruiting | Jinan | Shandong | China |
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| The 960th Hospital of the PLA Joint Logistics Support Force | Not yet recruiting | Jinan | Shandong | China |
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| The Fourth People's Hospital of Jinan | Not yet recruiting | Jinan | Shandong | China |
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| The Second People's Hospital of Liaocheng | Not yet recruiting | Liaocheng | Shandong | China |
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| The Affiliated Hospital of Qingdao University | Not yet recruiting | Qingdao | Shandong | China |
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| Tengzhou Central People's Hospital | Not yet recruiting | Tengzhou | Shandong | China |
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| Affiliated Hospital of Shandong Second Medical University | Not yet recruiting | Weifang | Shandong | China |
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| PLA Joint Logistics Support Force No.970 Hospital | Not yet recruiting | Yantai | Shandong | China |
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| Yantai Affiliated Hospital of Binzhou Medical University | Not yet recruiting | Yantai | Shandong | China |
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| Fudan University Minhang Hospital | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| Ruijin Hospital Luban Branch, Shanghai Jiao Tong University School of Medicine | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| Ruijin Hospital, Shanghai Jiao Tong University School of Medicine | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| Shanghai Tenth People's Hospital | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| Songjiang Hospital Affiliated to Shanghai Jiao Tong University School of Medicine | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine | Not yet recruiting | Shanghai | Shanghai Municipality | China |
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| The Second Affiliated Hospital of Xi'an Jiaotong University | Not yet recruiting | Xi’an | Shanxi | China |
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| Xi'an Gaoling District Hospital | Not yet recruiting | Xi’an | Shanxi | China |
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| The Eighth Affiliated Hospital,Sun Yat-sen University | Not yet recruiting | Shenzhen | Shenzhen | China |
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| Chengdu Wenjiang District People's Hospital | Not yet recruiting | Chengdu | Sichuan | China |
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| Sichuan Provincial People's Hospital | Not yet recruiting | Chengdu | Sichuan | China |
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| Guang'an People's Hospital | Not yet recruiting | Guang’an | Sichuan | China |
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| The People's Hospital of Jianyang City | Not yet recruiting | Jiancheng | Sichuan | China |
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| The Second Hospital of Tianjin Medical University | Not yet recruiting | Tianjin | Tianjin Municipality | China |
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| Tianjin Chest Hospital | Not yet recruiting | Tianjin | Tianjin Municipality | China |
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| Tianjin Fifth Center Hospital | Not yet recruiting | Tianjin | Tianjin Municipality | China |
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| Tianjin Hospital of Integrated Traditional Chinese and Western Medicine | Not yet recruiting | Tianjin | Tianjin Municipality | China |
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| Yunnan Provincial Hospital of Traditional Chinese Medicine | Not yet recruiting | Kunming | Yunnan | China |
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| Affiliated Hangzhou First People's Hospital,School of Medicine,Westlake University | Not yet recruiting | Hangzhou | Zhejiang | China |
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| The First Affiliated Hospital, Zhejiang University School of Medicine | Not yet recruiting | Hangzhou | Zhejiang | China |
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| Zhejiang Provincial People's Hospital | Not yet recruiting | Hangzhou | Zhejiang | China |
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| Huzhou Central Hospital | Not yet recruiting | Huzhou | Zhejiang | China |
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| The First Hospital of Jiaxing | Not yet recruiting | Jiaxing | Zhejiang | China |
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| The Second Hospital of Jiaxing | Not yet recruiting | Jiaxing | Zhejiang | China |
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| Beilun Branch of the First Affiliated Hospital of Zhejiang University School of Medicine | Not yet recruiting | Ningbo | Zhejiang | China |
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| Ningbo Medical Center Lihuili Hospital | Not yet recruiting | Ningbo | Zhejiang | China |
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| The Affiliated People'sHospital of Ningbo University | Not yet recruiting | Ningbo | Zhejiang | China |
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| Sir Run Run Shaw Hospital of Zhejiang University School of Medicine | Not yet recruiting | Shaoxing | Zhejiang | China |
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| Taizhou Central Hospital | Not yet recruiting | Taizhou | Zhejiang | China |
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| Taizhou Hospital of Zhejiang Province | Not yet recruiting | Taizhou | Zhejiang | China |
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| Yantai Yuhuangding Hospital | Not yet recruiting | Yantai | China |
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| Result |
| Li Y, Li Y, Zhang Z, Zhang J, Chen H, Yu H, Meng X, Yuan H, Shao L, Lu Y, Liu B, Xu J, Zhang Y, Li J, Han Y; HEARTRIP investigators. Efficacy and safety of yangxinshi versus trimetazidine on exercise tolerance in patients with coronary heart disease after percutaneous coronary intervention: Multicenter, double-blind clinical trial. Phytomedicine. 2024 Dec;135:156198. doi: 10.1016/j.phymed.2024.156198. Epub 2024 Nov 7. |
| 39076617 | Result | Zhang S, Shen Y, Liu P, Meng X, Hu D. Yangxinshi Tablet Improves Exercise Capacity for Patients with Coronary Heart Disease: Results from a Randomized, Double-Blind, Placebo-Controlled, and Multicenter Trial. Rev Cardiovasc Med. 2022 Jul 21;23(8):266. doi: 10.31083/j.rcm2308266. eCollection 2022 Aug. |
| 40013746 | Result | Rao SV, O'Donoghue ML, Ruel M, Rab T, Tamis-Holland JE, Alexander JH, Baber U, Baker H, Cohen MG, Cruz-Ruiz M, Davis LL, de Lemos JA, DeWald TA, Elgendy IY, Feldman DN, Goyal A, Isiadinso I, Menon V, Morrow DA, Mukherjee D, Platz E, Promes SB, Sandner S, Sandoval Y, Schunder R, Shah B, Stopyra JP, Talbot AW, Taub PR, Williams MS; Peer Review Committee Members. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2025 Jun 10;85(22):2135-2237. doi: 10.1016/j.jacc.2024.11.009. Epub 2025 Feb 27. |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| C000628007 | Yangxinshi |
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