Effects of Shen-Yuan-Dan on Periprocedural Myocardial Injury and the Number of Peripheral Blood Endothelial Progenitor Cells in Patients with Unstable Angina Pectoris Undergoing Elective Percutaneous Coronary Intervention

Abstract

Objectives. We aimed to investigate the effects of Shen-Yuan-Dan (SYD), a Chinese medicine preparation, on periprocedural myocardial injury (PMI) and the number of peripheral blood endothelial progenitor cells (EPCs) in patients with unstable angina pectoris (UA) who underwent elective percutaneous coronary intervention (PCI). Methods. Patients were randomly divided into the experimental (group A) and control (group B) groups through the random number table method. In group A, patients concurrently received the conventional western treatment and SYD orally (4 capsules/time, 3 times/d, from 3 d before surgery to 7 d after surgery). In group B, patients received conventional Western medicine treatment. Both groups underwent coronary angiography, and patients undergoing PCI were eventually included in the study. The following patient data were collected: incidence of PMI, serum CK-MB content before PCI, 4 h, 24 h, and 7 d after PCI, number of CD45dim/-CD34+CD309+ peripheral venous EPCs, and number of CD184 coexpressed EPCs. The incidence of adverse reactions and 30-day major adverse cardiovascular events (MACEs) were also recorded. Results. Sixty-two patients were finally included in this study, with 32 and 30 in groups A and B, respectively. In group A, the number of peripheral blood EPCs and the number of CD184 coexpressed EPCs at 1 h before surgery were higher than those at 3 d before surgery (37.24 ± 25.20 vs. 22.78 ± 9.60/ml; $P<0.001$ and 23.38 ± 15.30 vs. 13.54 ± 8.08/ml; $P<0.001$ , resp.). The number of peripheral blood EPCs and number of CD184 coexpressed EPCs at 4 h after surgery were lower than those at 1 h before surgery (25.30 ± 11.90 vs. 37.24 ± 25.20/ml; $P=0.019$ and 15.38 ± 8.78 vs. 23.38 ± 15.30/ml; $P=0.013$ , resp.), but there was no difference at 24 h and at 7 d after surgery in comparison with that at 1 h before surgery ( $P>0.05$ ). In group B, compared with that at 1 h before surgery, there existed a decline in the number of EPCs in peripheral blood and the number of CD184 coexpressed EPCs at 4 h after surgery, but without a statistical difference ( $P>0.05$ ). Comparing both groups, it was found that the incidence of PMI in group A was lower (6.25% vs. 26.67%; $P=0.04$ ), and the serum CK-MB content at 4 and 24 h after surgery was also lower than that in group B (17.33 ± 5.83 vs. 20.38 ± 4.32 U/l; $P=0.048$ and 15.79 ± 5.32 vs. 19.10 ± 4.93 U/l; $P=0.030$ , resp.). The number of EPCs in peripheral blood and the number of CD184 coexpressed EPCs in group A were higher than those in group B at 1 h before surgery (37.24 ± 25.20 vs. 22.36 ± 12.26/ml; $P=0.034$ and 23.38 ± 15.30 vs. 13.12 ± 14.62/ml; $P=0.013$ , resp.). In addition, there were no obvious adverse reactions and no 30-day MACEs in both groups during the trial. Conclusion. SYD can reduce PMI and promote the mobilization of EPCs in the perioperative period of elective PCI in patients with UA.