The Study Of Evaluation Of Instant Effect Of Kuanxiong Aerosol On Critical Coronary Lesions With Angina Based On Resting Full-cycle Ratio

ObjectiveA randomized controlled study was conducted to evaluate instant efficacy of Kuanxiong Aerosol in the treatment of patients with critical lesions of coronary heart disease and angina based on the resting-to-full cycle ratio(RFR),and to provide evidence of coronary physiology and imaging for the clinical treatment of patients with critical lesions and angina pectoris.MethodsThis study included 60 inpatients who met the inclusion and exclusion criteria from July 2021 to February 2022 from the Department of Cardiovascular Diseases,Guangdong Provincial Hospital of Traditional Chinese Medicine.By completely random allocation,they were divided into 30 cases in the experimental group and 30 cases in the control group.Coronary angiography was performed first,the RFR value of the critical lesion was determined,and the Visual Analogue Score(VAS)of the chest pain was completed.The experimental group was then continuously given Kuangxiong Aerosol 4 sprays while the control group was given normal saline 4 sprays.After 10 minutes,repeating the step of coronary angiography and acquiring the VAS.At the same time,coronary angiography images were analyzed to calculate the Corrected TIMI Frame Count(CTFC)of coronary arteries before and after intervention.The changes of RFR,the VAS and CTFC in the two groups before and after administration were analyzed and recorded to evaluate the clinical efficacy of Kuangxiong Aerosol on coronary heart disease with critical lesions.After the study,the case data of all subjects were collected and summarized,and SPSS 25.0statistical software was used for statistical analysis.Results1.Baseline comparison of sociodemographic data and clinical dataBefore intervention,There was no significant difference in the sociodemographic baseline(including gender,age,height,weight,BMI)and cardiovascular risk factors(smoking history,drinking history,hypertension,diabetes,hyperuricemia)and related laboratory tests(P>0.05).The baseline of the two groups was comparable.2.The primary outcome measure RFRBefore the intervention,there was no significant difference in the RFR value of stenotic lesions between the two groups(P>0.05),which was comparable.The RFR value of the experimental group before and after the intervention was significantly different(P<0.05),and the RFR value after the Kuanxiong Aerosol intervention was 0.02 higher than before(P<0.05,95% CI 0.010-0.050);There was no significant difference in the RFR value of the control group before and after the intervention(P>0.05).the RFR value after intervention and the RFR difference before and after intervention were statistically different between the two groups(P<0.05,95%CI 0.010-0.030).3.Secondary indicator CTFC.Before intervention,there was no statistical difference in CTFC value of stenotic lesions between the two groups(P>0.05),which was comparable.The CTFC value of the experimental group before and after the intervention was statistically different(P<0.05).);the RFR value of the control group before and after the intervention was statistically different(P<0.05),and the CTFC value after the saline intervention was 0.64 frames lower than that before(P<0.05,95% IC 0.32-0.96).The CTFC value after intervention and the difference of CTFC before and after intervention were statistically different between the two groups(P<0.05).Kuanxiong Aerosol reduced the CTFC value by 2.58 frames more than normal saline intervention(P<0.05,95%CI 1.93-3.87)and improve coronary blood flow velocity.4.Secondary outcome measure VAS of chest painBefore intervention,there was no significant difference in VAS of chest pain between the two groups(P>0.05),which was comparable.There was no statistical difference in the VAS between the two groups after the intervention and between before and after the intervention(P>0.05).Kuanxiong Aerosol did not improve VAS of chest pain.ConclusionCompared with normal saline,Kuanxiong Aerosol can immediately increase the RFR value and reduce the CTFC of coronary critical lesions,and the difference is statistically significant.However,this trial did not observe an improvement in the score of chest pain symptom,which may be related to the small sample size and the overall low baseline score of chest pain.Kuanxiong Aerosol can improve coronary physiology and increase coronary blood flow velocity,which may improve coronary microcirculation to a certain extent.