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

Figures & data

Figure 1. Kaplan-Meier analysis of time to primary and secondary end-points in hypertensive patients. A: Total coronary events, including recurrent non-fatal myocardial infarction (MI), fatal MI, sudden death and other coronary death; B: coronary heart disease death; and C: all-cause death.

Table I. Base-line clinical characteristics (n = 2704).

Variables	Placebo (n = 1341)	Xuezhikang (n = 1363)	P-value
Male/female	1054/287	1093/270	0.31
Age, mean ± SD
Male	59.2 ± 9.5	59.4 ± 9.2	0.29
Female	63.2 ± 7.1	63.0 ± 6.6	0.28
Body mass index (kg/m ^2 ), mean ± SD	25.1 ± 2.8	25.2 ± 3.0	0.26
Heart rate (beats per minute)	74.9 ± 9.1	74.7 ± 9.7	0.12
Medical History, n (%)
Smoking	442 (33.0)	434 (31.8)	0.53
Alcohol consumption	202 (15.1)	184 (13.5)	0.25
Diabetes	186 (11.0)	209 (15.3)	0.38
Medication, n (%)
Aspirin	1264 (94.3)	1277 (93.7)	0.54
(β-Blocker	747 (55.7)	791 (58.0)	0.22
ACEI	725 (54.1)	710 (52.1)	0.30
Calcium channel blocker	578 (43.1)	598 (43.9)	0.69
Nitrate	1223 (91.2)	1281 (89.4)	0.11

ACEI = angiotensin-converting enzyme inhibitor.

Table II. Changes of lipid profiles (mg/dL) and blood pressure (mmHg) after Xuezhikang therapy.

Lipid profile (mg/dL) and blood pressure (mmHg)		Placebo (n = 1341)	Xuezhikang (n = 1363)	P-value
Total cholesterol	Base-line	208.1 ± 25.8	207.6 ± 26.1	0.59
	After therapy	203.1 ± 37.2^a	185.0 ± 34.1^a	<0.001
Triglyceride	Base-line	166.0 ± 75.7	164.8 ± 76.1	0.68
	After therapy	156.8 ± 82.9^b	146.0 ± 76.6^a	0.00
High-density lipoprotein cholesterol	Base-line	45.9 ± 14.4	45.9 ± 14.5	0.89
	After therapy	47.0 ± 12.8	48.0 ± 13.0^a	0.06
Low-density lipoprotein cholesterol	Base-line	129.4 ± 28.9	129.2 ± 28.2	0.89
	After therapy	125.1 ± 35.9^b	107.4 ± 32.2^a	<0.001
Blood pressure Systolic
	Base-line	137.7 ± 16.8	137.7 ± 16.5	0.94
	After therapy	132.9 ± 14.5^a	132.2 ± 14.3^a	0.18
Diastolic	Base-line	84.4 ± 10.1	84.7 ± 10.3	0.46
	After therapy	80.7 ± 9.5^a	80.4 ± 8.7^a	0.34

^aP < 0.05 compared with base-line.

^b P < 0.05 compared with base-line.

Table III. Comparison of various events between Xuezhikang and placebo group.

Clinical events	Placebo (n = 1341)	Xuezhikang (n = 1363)	Intergroup difference (%)	P-value
CHD events
Non-fatal MI	73 (5.4)	30 (2.2)	–59.6	<0.001
Fatal MI	18 (1.3)	13 (1.0)	–29.2	0.34
Sudden death	45 (3.4)	32 (2.4)	–30.1	0.12
Other CHD death	24 (1.8)	16 (1.2)	–34.6	0.19
Total CHD death	87 (6.5)	61 (4.5)	–30.0	0.001
Total CHD events	160 (11.9)	91 (6.7)	–43.0	0.02
Common events
Stroke survival	58 (4.3)	39 (2.9)	–34.0	0.07
Stroke death	10 (0.8)	8 (0.6)	–21.3	0.61
Total stroke	68 (5.1)	47 (3.5)	–32.0	0.06
Cancer survival	9 (0.7)	10 (0.7)	9.0	0.85
Cancer death	21 (1.6)	7 (0.5)	–65.5	0.001
Total cancer	30 (2.2)	17 (1.3)	–44.2	0.06
PCI/CABG	57 (4.3)	44 (3.2)	–24.0	0.19
Total common events	155 (11.6)	108 (7.9)	–31.5	0.00
Other cardiovascular death	2 (0.2)	1 (0.1)	–53.3	0.63
Total death	124 (9.3)	81 (5.9)	–35.8	0.001

CHD = coronary heart disease; MI = myocardial infarction; PCI/CABG = percutaneous coronary intervention/coronary artery by-pass graft; Intergroup difference = percentage difference of events between the placebo and Xuezhikang.

Table IV. Comparison of effects of Xuezhikang treatment on clinical events between hypertensive (n = 2704) and non-hypertensive patients (n = 2166) with previous myocardial infarction.

	Events in groups (%)
Events and groups	Placebo	Xuezhikang	Relative risk (95% CI)	P-value	NNT
CHD events
Hypertensive	11.9	6.7	0.68 (0.48–0.97)	<0.01	19
Non-hypertensive	8.5	4.5	0.48 (0.37–0.65)	<0.01	25
CHD death
Hypertensive	6.5	4.5	0.61 (0.41–0.80)	<0.01	50
Non-hypertensive	4.3	2.9	0.66 (0.40–0.91)	<0.05	71
All-cause death
Hypertensive	9.3	5.9	0.65 (0.42–0.77)	<0.01	30
Non-hypertensive	5.9	4.2	0.62 (0.39–0.95)	<0.05	59

CHD = coronary heart disease; CI = confidence interval; NNT = number needed to treat.