Chinese Herbal Medicine Boosts Heart Failure Care
A large placebo-controlled trial (a rigorous tool to examine cause-effect relationships) was presented at the European Society of Cardiology (ESC) 2023 Congress.
Heart failure with reduced ejection fraction (HFrEF) is a condition in which the left ventricle loses its ability to contract normally. The heart can’t pump with enough force to push enough blood into circulation.
In this study, researchers have shown that a traditional Chinese herbal remedy known as Qiliqiangxin can significantly improve the treatment of heart failure with reduced ejection fraction.
This herbal medicine composed of 11 plant-based ingredients, known for their diuretic effects, vasodilation, and cardiotonic activity, has shown a remarkable ability to reduce the risk of cardiovascular death and hospitalization due to heart failure by more than 20%.
The findings of this study, presented at the European Society of Cardiology Congress, shed light on a potential new approach to managing heart failure.
Let’s take a closer look
The study, known as QUEST, involved over 3,000 patients with HFrEF who were randomly assigned to take Qiliqiangxin or a placebo three times a day.
These patients were already receiving a standard triple-therapy regimen for heart failure, which includes medications like angiotensin-converting enzyme inhibitors, beta-blockers, and mineralocorticoid receptor antagonists.
The goal was to determine whether Qiliqiangxin could provide additional benefits beyond the existing treatment.
The results of the study were quite promising.
Patients who took Qiliqiangxin experienced a 22% reduction in cardiovascular death and heart failure hospitalization compared to those on a placebo.
This reduction was consistent across different subgroups of patients, although it was more significant, for instance, in those with an ischemic cause of heart failure.
The study showed potential benefits of Qiliqiangxin, but some questions need to be answered. For instance, the low enrollment of patients taking SGLT-2 inhibitors, which are now a standard part of heart failure treatment.
Despite these questions, the study offers hope for individuals living with HFrEF and highlights the potential of traditional Chinese medicine in modern healthcare.
Qiliqiangxin may become a valuable addition to the arsenal of treatments for heart failure, particularly for those who cannot tolerate certain components of the standard therapy.
Qiliqiangxin capsules were well-tolerated, with no major differences between the two groups in adverse events, including gastrointestinal symptoms, worsening renal function and increased liver enzymes.
However, four Qiliqiangxin capsules, taken three times a day, could be challenging for some patients.
Principal investigator Professor Xinli Li of the First Affiliated Hospital of Nanjing Medical University, Nanjing, China said:
“To our knowledge, this was the first randomized, double-blind controlled trial of a traditional Chinese medicine for the treatment of chronic heart failure. Our findings demonstrate meaningful clinical benefit with Qiliqiangxin in patients with HFrEF, which supports the use of Qiliqiangxin as an adjunct therapy for treating heart failure.”
Several questions remain about the real benefits of this type of treatment. Especially because these herbal products are difficult to standardize.
Researchers also suggested that it will be important to dissect the relative contribution of the different active ingredients of Qiliqiangxin.
References
Traditional Chinese Medicine Improves Outcomes in HFrEF https://www.medscape.com/viewarticle/995876?src=soc_tw_share via @medscape
First randomised trial of traditional Chinese medicine for heart failure shows benefit https://www.escardio.org/The-ESC/Press-Office/Press-releases/First-randomised-trial-of-traditional-Chinese-medicine-for-heart-failure-shows-benefit/