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Traditional Chinese Medicine Qiliqiangxin Shows Promise in Reducing Hospitalisation and Cardiovascular Death for Heart Failure Patients

A breakthrough study presented at ESC Congress 2023 revealed that qiliqiangxin, a traditional Chinese medicine, has the potential to significantly reduce hospitalisation rates and cardiovascular death in patients with heart failure and reduced ejection fraction (HFrEF). This research, presented in a Hot Line session, provides a glimmer of hope for individuals suffering from this debilitating condition.1

Understanding Qiliqiangxin

Qiliqiangxin is an extract derived from 11 types of herbs, as listed in Table 1 of the study.2 Preliminary investigations have already demonstrated its efficacy in reducing N-terminal pro–B-type natriuretic peptide (NT-proBNP) levels and improving heart failure symptoms when combined with conventional heart failure treatment.3 Moreover, preclinical studies have shown that qiliqiangxin possesses properties that can mitigate myocardial fibrosis and cardiac remodeling, suggesting its potential to improve heart health.4-7

The QUEST Trial: Evaluating the Efficacy of Qiliqiangxin

The QUEST trial aimed to evaluate the clinical efficacy and safety of qiliqiangxin in improving heart failure outcomes for HFrEF patients. This large-scale trial was conducted at 133 hospitals in mainland China and Hong Kong SAR of China.

The study enrolled adult HFrEF patients who had a left ventricular ejection fraction of 40% or below and NT-proBNP levels of 450 pg/ml or higher. These patients were required to have been on a stable standardised baseline treatment regimen for at least two weeks before participation. They were then randomly assigned in a 1:1 ratio to receive qiliqiangxin or a placebo, in addition to their standard medications for chronic heart failure. The primary endpoint of the trial was a composite of rehospitalisation for worsening heart failure or cardiovascular death.

The analysis included a total of 3,110 patients, with 1,555 in the qiliqiangxin group and 1,555 in the placebo group. The average age of the participants was 62 years, with 72.1% of them being male. At the beginning of the trial, the mean left ventricular ejection fraction was 32%, and the median NT-proBNP level was 1730.80 pg/ml.

Promising Results and Secondary Endpoints

After a median follow-up period of 18.3 months, the primary endpoint occurred in 389 patients (25.02%) in the qiliqiangxin group compared to 467 patients (30.03%) in the placebo group. This represents a hazard ratio of 0.78 with a 95% confidence interval of 0.68 to 0.90 (p).

The study also looked at secondary endpoints, particularly the change in serum NT-proBNP levels between baseline and three-month follow-up. The qiliqiangxin group showed a greater decrease in NT-proBNP levels (-444.00 [interquartile range -1401.00 to 85.00]) compared to the placebo group (-363.00 [interquartile range -1280.00 to 183.00]) (p=0.047), supporting the findings of previous pilot studies.3

Safety and Tolerability

Analysis of safety endpoints revealed no significant difference in all-cause mortality between the qiliqiangxin group (14.21% or 221 patients) and the placebo group (16.85% or 262 patients) (hazard ratio = 0.84, 95% CI = 0.70 to 1.01, p=0.058). Importantly, qiliqiangxin was well-tolerated, with no major discrepancies observed between the two groups in terms of adverse events, including gastrointestinal symptoms, worsening renal function, and increased liver enzymes.

A Step Towards Heart Failure Treatment

Professor Xinli Li of the First Affiliated Hospital of Nanjing Medical University, Nanjing, China, commended the study’s findings, stating, “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 support the use of qiliqiangxin as an adjunct therapy for treating heart failure.”

How AI legalese decoder Can Help:

The AI legalese decoder is designed to simplify complex legal jargon and provide comprehensive explanations of legal documents. In the context of this study, the AI legalese decoder can assist by breaking down the trial protocols and outcomes for HFrEF patients treated with qiliqiangxin and explaining the significance of the study’s findings. This can enhance both healthcare professionals’ and patients’ understanding of the trial results and facilitate informed decision-making regarding treatment options for heart failure.

Table 1: Ingredients of qiliqiangxin

Quest HL2 Table 1.png

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