The traditional Chinese medicine qiliqiangxin reduces hospitalization for heart failure and cardiovascular death in patients with heart failure and a reduced ejection fraction (HFrEF), according to late breaking research presented in a Hot Line session today at ESC Congress 2023.
Qiliqiangxin is a traditional Chinese medicine extract obtained from 11 types of herbs . In a pilot study, qiliqiangxin reduced N-terminal pro-B-type natriuretic peptide levels and improved heart failure symptoms in patients with HFrEF when added to established heart failure treatment. Preclinical studies have also indicated that qiliqiangxin has beneficial effects on attenuating myocardial fibrosis and cardiac remodeling.
The trial enrolled adult HFrEF patients with a left ventricular ejection fraction of 40% or below and NT-proBNP of 450 pg/ml or higher who had been on a stable standardized baseline treatment regimen for at least two weeks prior to enrolment. Patients were randomized in a 1:1 fashion to receive qiliqiangxin or placebo on top of standard medications for chronic heart failure. The primary endpoint was a composite of rehospitalization for worsening heart failure or cardiovascular death.
During a median follow-up of 18.3 months, the primary endpoint occurred in 389 patients in the qiliqiangxin group and in 467 patients in the placebo group . This effect was related to both lower risks of rehospitalization for worsening heart failure and cardiovascular death in the qiliqiangxin group.
Analysis of safety endpoints demonstrated no significant difference in all-cause mortality, which occurred in 221 patients in the qiliqiangxin group and 262 patients in the placebo group . 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.
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