Effects of Danhong injection combined with intravenous thrombolysis on cardiac function, myocardial zymogram and lipoprotein-associated phospholipase A2 level in older adult patients with acute myocardial infarction / 中国基层医药

ABSTRACT

Objective:To investigate the effects of Danhong injection combined with intravenous recombinant tissue plasminogen activator (rt-PA) on cardiac function, myocardial zymogram and lipoprotein associated phospholipase A2 (Lp-PLA2) level in older adult patients with acute myocardial infarction (AMI). Methods:Eighty older adult patients with acute myocardial infarction who received treatment in Community-based General Hospital of Shaoxing Central Hospital, China between January 2017 and December 2019 were included in this study. They were randomly assigned to receive either intravenous thrombolysis with rt-PA (control group, n = 40) or Danhong injection combined with intravenous thrombolysis with rt-PA (observation group, n = 40). The changes in traditional Chinese medicine syndrome score, left ventricular ejection fraction, left ventricular end diastolic diameter, creatine kinase, creatine kinase-MB and lipoprotein associated phospholipase A2 level as well as adverse cardiovascular events were compared between the control and observation groups. Results:After treatment, the score of chest tightness, dark purple tongue, palpitation and shortness of breath in the two groups were decreased. After treatment, the score of chest tightness, dark purple tongue, palpitation and shortness of breath in the observation group was (2.13 ± 0.31) points, (1.98 ± 0.41) points, (1.77 ± 0.29) points, respectively, which was significantly lower than that in the control group [(2.98 ± 0.37) points, (2.52 ± 0.56) points, (2.13 ± 0.32) points, t = 11.137, 4.920, 5.272, all P < 0.001]. After treatment, left ventricular end diastolic diameter in each group was decreased compared with before treatment. After treatment, left ventricular end diastolic diameter in the observation group was significantly lower than that in the control group [(46.12 ± 4.11) mm vs. (49.74 ± 4.32) mm], and left ventricular ejection fraction in the observation group was significantly higher than that in the control group [(47.02 ± 3.55) % vs. (43.25 ± 4.10) %, t = 3.839, 4.396, both P < 0.001). After treatment, Lp-PLA2, creatine kinase, creatine kinase-MB levels in each group were decreased compared with before treatment. After treatment, Lp-PLA2, creatine kinase, creatine kinase-MB levels in the observation group were (171.02 ± 12.52) μg /L, (10.52 ± 2.11) U/L, (24.12 ± 3.52) U/L), respectively, which were significantly lower than those in the control group [(189.63 ± 11.98) μg/L, (14.71 ± 2.62) U/L, (32.79 ± 4.79) U/L), t = 6.792, 7.877, 9.224, all P < 0.001]. The incidence of adverse cardiovascular events in the observation group was significantly lower than that in the control group (5.00% vs. 22.50%, χ2 = 5.165, P < 0.05). Conclusion:Danhong injection combined with intravenous rt-PA for the treatment of acute myocardial infarction in older adult patients can greatly decrease traditional Chinese medicine syndrome score, improve cardiac function, regulate myocardial zymogram and Lp-PLA2 levels, and decrease the incidence of adverse cardiovascular events.