The Effect of Tongguan Capsule for MicroRNA Profiles in Coronary Heart Disease Patients

Study Overview
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Brief Summary
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The purpose of this study is to test the expression of microRNAs related to the syndromes after the intervention of Tongguan capsule,preliminarily to investigate the mechanism of the effects of Tongguan capsule, and provide the biological foundation of curative effect of Tongguan capsule.

Detailed Description
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The primary end points is the core of the whole experiment scheme. miRNAs regulate gene expression posttranscriptionally by degrading messenger RNA (mRNA) targets and by blocking their translation Secondary endpoints will include The adverse cardiac clinical events (MACE) in terms of cardiac death,periprocedural myocardial infarction (MI),spontaneous MI and target vessel revascularization(TVR). Related parameters of qi and blood are the material basis of blood conversion and objective performance is used to evaluate the effect on Tongguan capsule on patients with blood stagnation, which can be either interpretation theory of qi deficiency and blood stagnation and mutual transformation between qi and blood can find targets through Tongguan capsule on blood . Routine laboratory tests are used for screening patients basic situation and ensure the safety of the experiment The traditional Chinese medicine syndrome scale Including the the score of deficiency of qi and score of blood stasis syndrome mainly used to identify patients with the traditional Chinese medicine syndrome type Approximately 100 patients in Coronary Heart Disease Patients with Blood Stasis Syndrome undergoing percutaneous coronary intervention will be enrolled and randomized to divided into Qi -stagnation and blood stasis, Qi- deficiency and blood stasis, after the PCI surgery, Qi deficiency and blood stasis group were randomly divided into Tongguan capsule group and the control group, and qi stagnation and blood stasis group, too ,giving patients through Tongguan capsule 3 pills three times a day(1.5g/day), once every three months follow-up, after have been followed up to six months

Official Title
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The Effect of Tongguan Capsule for MicroRNA Profiles Between Qi-Stagnation and Qi-Deficiency in Coronary Heart Disease Patients With Blood Stasis Syndrome Undergoing Percutaneous Coronary Intervention

Conditions
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Coronary Heart Disease, Acute Myocardial Infarction

Intervention / Treatment
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* Drug: Tongguan capsule
* Drug: placebo capsule


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: In line with the diagnostic criteria for acute coronary syndrome (ACS), coronary angiography confirmed for coronary heart disease (CHD), parallel Percutaneous transluminal coronary angioplasty( PTCA) and/or coronary stent implantation was successful Postoperative routine drug treatment Traditional Chinese Medicine syndrome differentiation of qi -deficiency and qi -stagnation blood stasis or blood stasis license Aged 35 to 75 years old Must sign a consent form. Exclusion Criteria: Renal insufficiency, the male serum creatinine > 2.5 mg/dl (> 220 umo/l), women > 2.0 mg/dl (> 175 umo/l) With obvious liver disease or Alanine aminotransferase ( ALT)， Aspartate aminotransferase ( AST), 3 times higher than normal ceiling Serious cardiac insufficiency (EF < 35%) Uncontrolled patients with high blood pressure Merger or severe valvular heart disease in acute cerebrovascular disease Random blood glucose or greater tendency for 13.7 / L diabetes or glycosylated hemoglobin 9.5% or more Patients with severe mental illness Patients with malignant tumor or life expectancy in less than three years Patients with severe hematopoietic system disease Refused to sign a consent form, or estimated compliance is poorer, follow-up possibilities claim; Pregnancy or ready to pregnant women, nursing mothers; Participated in nearly three months, or is in other clinical subjects . -

Ages Eligible for Study
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Minimum Age: 35 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Tongguan capsule<br>Tongguan capsule (0.5 g tid. for 6 months) | Drug: Tongguan capsule<br>* eligible participants were randomized to receive Tongguan capsule ( 1.5 g/day for six months immediately after PCI)<br>|
| Placebo Comparator: placebo capsule<br>same volume/day of placebo capsule (0.5 g tid. for 6 months) | Drug: placebo capsule<br>* eligible participants were randomized to receive placebo capsule ( 1.5 g/day for six months immediately after PCI)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| miRNAs spectrum | Test the expression of microRNAs related to the syndromes after the intervention of Tongguan capsule,preliminarily to investigate the mechanism of the effects of Tongguan capsule, and provide the biological foundation of curative effect of Tongguan capsule. | six months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| major adverse cardiac event | frequency of the reported cardiovascular events (defined as cardiogenic death, stroke, recurrent myocardial infarction, readmission on account of deterioration of congestive heart failure or unstable angina, target vessel revascularization) | six months | 
| Renin predicts cardiovascular homeostasis and ventricular remodeling | renin（ng/ml） predicts cardiovascular homeostasis and blood pressure maintenance and plays an important role in ventricular remodeling | 6 months | 
| Ang II predicts cardiovascular homeostasis and ventricular remodeling | Ang II（pg/ml） predicts cardiovascular homeostasis and blood pressure maintenance and plays an important role in ventricular remodeling | 6 months | 
| Serum E | Acute coronary syndrome is caused by atherosclerotic plaque instability and rupture. The stability of plaque is closely related to inflammation.Serum E (pmol / L) is an important pathway of various immune and inflammatory regulation, which promotes the development of atherosclerosis and is a risk factor for atherosclerosis. | 6 months | 
| Inflammatory mediators | Tumor Necrosis factor alpha (ng/L)and Interleukin-6，IL-6 (ng/L) measure of the general situation of patients | 6 months | 
| Brain Natriuretic Peptide | B-type natriuretic peptide（pg/ml） is a neurohormone synthesized in the cardiac ventricles upon ventricular pressure overload and ventricular dilatation | 6 months | 
| Echocardiography measure of left ventricular systolic function | Evaluation of left ventricular systolic function by left ventricular ejection fraction( LVEF) (%) | 6 months | 
| Echocardiography measure of left ventricular diastolic function | Left ventricular end diastolic diameter (LVEDD) (mm )measure of left ventricular diastolic function in patients | 6 months | 
| New York Heart Association functional classification | I Cardiac disease, but no symptoms and no limitation in ordinary physical activity, e.g. no shortness of breath when walking, climbing stairs etc. II Mild symptoms (mild shortness of breath and/or angina) and slight limitation during ordinary activity. III Marked limitation in activity due to symptoms, even during less-than-ordinary activity, e.g. walking short distances (20-100 m).Comfortable only at rest. IV Severe limitations. Experiences symptoms even while at rest. Mostly bedbound patients. | 6 months | 
| Coronary angiography | Quantitative coronary angiography in the stenosis degree, 25%, 50%, 75%, 90%, 99%, 100%, 1, 2, 4, 6, 8,, 16, 32, and, respectively. Scoring multiplication will segment coefficients corresponding to the degree of stenosis and the stenosis of total score that is the sum of Gensini score of coronary artery stenosis in the patients. | 6 months | 
| Seattle Angina Questionnaire score | The Seattle Angina Questionnaire is a valid and reliable instrument that measures five clinically important dimensions of health in patients with coronary artery disease (physical limitation, anginal stability, anginal frequency, treatment satisfaction, and disease perception). (in Units on a Scale). | 6 months | 
| The traditional Chinese medicine syndrome scale | The traditional Chinese medicine syndrome scale Including the the score of deficiency of qi and score of blood stasis syndrome mainly used to identify patients with traditional Chinese medicine syndrome type | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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acute coronary syndrome, Tongguan capsule, miRNAs