Impact of Xuezhikang on coronary events in hypertensive patients with previous myocardial infarction from the China Coronary Secondary Prevention Study (CCSPS)

Abstract

Background. The lowering of cholesterol concentrations in individuals at high risk for cardiovascular disease improves clinical outcome. Xuezhikang has a marked impact on lipids.

Methods. In this randomized, double-blinded, placebo-controlled, parallel-group clinical trial, a total of 2704 hypertensive patients with previous myocardial infarction (MI) were assigned either to placebo (n = 1341) or to Xuezhikang (0.6 g twice daily, n = 1363) for an average of 4.5 years. The primary end-point was recurrent coronary events; the secondary end-point was all-cause mortality and other clinical events, including adverse effects.

Results. There were no differences between the Xuezhikang and placebo group in base-line characteristics. However, Xuezhikang treatment reduced the incidence of coronary events by 43.0% (P = 0.02), deaths from coronary heart disease (CHD) by 30.0% (P < 0.01), and all-cause mortality by 35.8% (P = 0.001).

Conclusions. This study, for the first time, demonstrated that long-term Xuezhikang therapy resulted in significant reduction in cardiovascular events and death in Chinese hypertensive patients with previous MI in a safe manner.

Key words::

• Hypertension
• myocardial infarction
• statin
• Xuezhikang

Acknowledgements

Dr Jian-Jun Li and Dr Zong-Liang Lu contributed equally to this study. Dr Jian-Jun Li and Zong-Liang Lu collected and interpreted the data and designed and prepared the manuscript. Dr Bao-Min Du collected data and helped with data analysis. Dr Zuo Chen analyzed data. Dr Yang-Feng Wu supervised data analysis. Dr Xue-Hai Yu and Yu-Cheng Zhao were involved in the acquisition of subjects and data.

Declaration of interest: This study was supported by the project (No. 96-906-02-10) of the National Medical Science and Technological Foundation during the ninth 5-year plan in China. Dr Jian-Jun Li and Dr Zong-Liang Lu, Wen-Rong Kou, Zuo Chen, Yang-Feng Wu, Xue-Hai Yu, Yu-Cheng Zhao received financial support by grants from National Medical Science and Technological Foundation, and Beijing WBL Peking University Biotech Co. Ltd for the present study.

The sponsors helped fund the study but had no input into the design, subject recruitment, data collections, analysis, or preparation of the manuscript.

Appendix

Investigators

Fu Wai Hospital (Xu YS, Gu DF, Jia X, Chen Z, Sun JL, Chen J); Peking University Shougang Hospital (Yu XH, Wang JH, Wang N, Zheng RP, Zhang SH); Heilongjiang Yichun Forrest Industry Central Hospital (Liu CX, Sun LH, Zhao YC, Lin Y, Huang JB); Capital Medical University Beijing Chaoyang Hospital (Hu DY, Yang XC, Liu YZ, Gao MM, Zhang P); Liaoning People’s Hospital (Deng CX, Liu Y, Li ZQ, Shi YQ, Hu TS); Chongqing Medical University First Hospital (Chen YZ, Tan S, Zhao WR, Deng GL, Huang WJ); Hebei Baoding Second Hospital (Zhang JC, Yu H, Shi QS, Wang XZ, Jiang B); Shandong University Qilu Hospital (Pan XR, Li L, Bu PL, Shu MQ, Xu QL); Peking University First Hospital (Zhang JH, Ding WH, Li L, Yang JJ, Su JL); Anshan Steel Company Tiedong Hospital (Zhao WD, Liu X, Li LJ, Yang JF, Wang QS); Institute of Cardiology, Tianjing Medical University Second Hospital (Huang TG, Li LF, Zhou LJ); Peking University Third Hospital (Guo JX, Li WH, Li ZP); Beijing Fangshan First Hospital (Zhang XG, Peng XM, An YW); Xi’an Jiaotong University First Hospital (Shu J, Ma LT, Ge H, Zhang MJ, Lv ZR); Beijing Haidian Hospital (Li JH, Yang JW, Zhang L); Jiangsu People’s Hospital (Cheng YL, Chen JG, Zhou CW, Zhang HH); Harbing Medical University First Hospital (Huang YL, Qu XF, Li JJ, Guo H); Shandong Dezhou Hospital (Wang GX, Hao SZ, Li SJ, Chang HS); Beijing Military Area General Hospital (Zhou SM, Liang HQ, Cao SJ, Liu JG); Shanxi Hanzhong People’s Hospital (Yang J, Zhao MY, Lv Y, Xu SL); Central South University Xiangya Second Hospital (Wang ZL, Zhao SP, Li XP, Luo XL); Beijing Jiangong Hospital (Li YP, Lei Y); Liaoyang Central Hospital (Fan SQ, Wang LH, Zhao LJ, Zhao YC); Beijing Chuiyangliu Hospital (Xue SW, Li J, Xu SY, Cao YG); Fudan University Zhongshan Hospital (Tong BG, Wang W, Xu SK); Shanxi University First Hospital (Chen HZ, Guo WL, Wang LJ, Yan XM); Central Hospital of Jinzhou, Liaoning (Li Y, Wei LP, Qiao L, Gao SS); Peking Union Medical Collage Hospital (Jing XF, Wang CH, Tang BX, Bai H); Qinghai Medical Collage Hospital (Li L, Liu Y, Li YP, Mei F); Shandong Liaocheng Second People’s Hospital (Yuan KZ, Zhang Y, Sun YR, Chen L); Shanxi Cardiovascular Hospital (Xue SR, Wang JP, Li B, Liu ZM); Capital Medical University Beijing Friendship Hospital (Shen LH, Liang JR, Zhang Y, Song YL); Tianjing Medical University General Hospital (Sun YM, Wan Z, Xu YH, Zhang WJ); Shandong Dezhou People’s Hospital (Mu RQ, Li KQ, Wei YP, Wang SM); Shandong Binzhou People’s Hospital (Fan YJ, An KY, Guo J, Li AP); China Medical University First Hospital (Zeng DY, Huo HY, Chen Y, Song LX); Peking University People’s Hospital (Jiang BQ, Guo DJ, Chen H, Li L); Tianjin Thoracic Hospital (Yin YQ, Mao YM, Miao L, Guo YJ); Shenyang Fifth People’s Hospital (Li SJ, Cui SS, Diao Q, You XM); Northeast Electricity Central Hospital (Jiang B, Zhu LT, Liu JM, Fang L); Guangdong People’s Hospital (Lin SG, Chen LY, Huang WH); China—Japan Friendship Hospital (Zheng ZG, Ke YN, Wang Y); Qinhuangdao First Hospital (Wang QS, Liang H); Jinan Fourth People’s Hospital (Jia RY, Wang T, Liu CX); Nanjing First Hospital (Geng QJ, Duan BX); Rongcheng People’s Hospital (Fang CQ, Wang JY); Capital Medical University Beijing Tongren Hospital (Chang ZW, Qi Y); Hebei Langfang People’s Hospital (Wang X, He WS); PLA General Hospital (Ye P, Liu YC); Dalian Medical University Second Hospital (Li CY, Ye JJ); Xinjiang Medical University First Hospital (He BX, Zhang XY, Hong XF); Beijing Military Area General Hospital Division (Shi RG, Wei WL); Tianjin Tianhe Hospital (Sun JJ, Li ZC); Henan Xinxiang Second People’s Hospital (Zhang XJ, He P); Henan Kaifeng First People’s Hospital (Gao W, He YJ); Beijing Tongzhou District Luhe Hospital (Zhang HB, Li ND); Shandong Shengli Oil Field Shengli Hospital (He XN, Chen GL); Western China Hospital (Wang JL); Huazhong University of Science & Technology Tongji Medical College Wuhan Union Hospital (Liang GF, Dai GZ); Beijing Fuxing Hospital (Wang Q); Henan People’s Hospital (Jin HY); Ministry of Health Institute of Gerontology (Wang S).