editorial complementary/alternative medicine in...

Hindawi Publishing CorporationEvidence-Based Complementary and Alternative MedicineVolume 2013, Article ID 538346, 2 pageshttp://dx.doi.org/10.1155/2013/538346

EditorialComplementary/Alternative Medicine inCardiovascular Diseases 2013

Ke-ji Chen,1 Ka Kit Hui,2 Myeong Soo Lee,3 and Hao Xu1

1 China Heart Institute of Chinese Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing 100091, China2 Center for East-West Medicine, University of California, Los Angeles, Santa Monica, CA 90404, USA3Medical Research Division, Korea Institute of Oriental Medicine, Daejeon 305-811, Republic of Korea

Correspondence should be addressed to Ke-ji Chen; keji [email protected]

Received 12 November 2013; Accepted 12 November 2013

Copyright © 2013 Ke-ji Chen et al. This is an open access article distributed under the Creative Commons Attribution License,which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cardiovascular diseases (CVDs) are the leading cause ofdeath worldwide, and the mortality is likely to furtheraccelerate in many developing countries. In 2008, almostone in three deaths all over the world was attributed toCVDs. It is also estimated that by 2030 over 23 milliondeaths from CVDs will occur each year. Despite advances inmodern management of CVDs, either revascularization ormedical therapy, complications related to these proceduresand recurrent acute cardiovascular events still afflict patients.Meanwhile, patients with CVDs often suffer from unfavor-able quality of life. In recent decades, the potential benefitof complementary/alternative medicine (CAM) therapy inimproving CVDs prognosis has drawn more and moreattention, and the use of CAM by physicians and patientshas also increased markedly. However, the evidence of CAMfor CVDs patients and the research on mechanism of actionsare still insufficient. Last year, the published special issuenamed “The potential benefit of complementary/alternativemedicine in cardiovascular diseases” got a great success, whichfacilitates the compilation of this special issue 2013. Webelieve that such a series can have a long-term impact, andin time gather a community around it in much the same waya successful annual conference does.

In this issue, original research papers and reviews fromdifferent parts of the world including China, Republic ofKorea, USA, Germany, and Malaysia are presented. Thesepapers are focused on the mechanism of action and theclinical application of CAM in treating CVDs. In the clinicaltrials, the benefits of Chinese medicine and some other CAM

therapies for CVDs patients were demonstrated. A multicen-ter prospective cohort study showed that heart failure, age≥65 years old, andmyocardial infarctionwere associatedwithan increase in one-year follow-up incidence of major adversecardiac events (MACEs) in hospitalized coronary heart dis-ease patients, and integrative medicine showed a tendencyfor reducing the incidence of MACEs. The similar benefit ofintegrative medicine therapy for patients with acute coronarysyndrome after PCI was showed in amulticenter randomizedcontrolled trial (RCT), 5C trial. Another RCT compared theeffectiveness of Qi-shen-yi-qi dripping pills (QSYQ) withthat of aspirin in the secondary prevention of myocardialinfarction. This trial did not show significant difference ofprimary and secondary outcomes between aspirin andQSYQ,which suggest QSYQ might be an alternative medicationfor patients’ intolerance of aspirin in patients who have hadan MI. Specifically, a new potential biomarker of “toxinsyndrome” in coronary heart disease patientswas proposed ina paper containing two clinical trials. The authors concludedthat the new biomarker “inter-alpha-trypsin inhibitor heavychain H4” might have a potential role in early identifyinghigh-risk coronary heart disease patients in stable period.Most of the experiment researches in this issue were focusedon Chinese medicine and Korean medicine. Two researchesexplored the role and mechanism of Qiliqiangxin capsule(QL), an oral Chinese proprietary medicine, for arrhythmiaand heart failure, respectively. A pharmacological researchshowed that blocking androgen receptor could abolish theability of Panax ginseng to protect the heart frommyocardial

2 Evidence-Based Complementary and Alternative Medicine

ischemia reperfusion injury.The benefit of Doinseunggitang,a Korean traditional prescription, on the treatment and pre-vention of diabetic vascular complications was also describedin a study. A systematic review suggested that oral Panaxnotoginseng preparation could relieve angina pectoris relatedsymptoms. Meanwhile, the potential benefit of Qiju DihuangWan, a Chinese herbal prescription, on the treatment ofessential hypertension was also reviewed. Additionally, yogawas recommended as an effective intervention for reducingblood pressure in a systematic review.

Due to indefinite mechanism of actions and lackingof high quality evidence, traditional Chinese medicine andother traditionalmedicine worldwide are considered as CAMin Western countries. In this case, original researches onmechanism of actions play an important role in the mod-ernization and internationalization of CAM and should befurther strengthened in future researches. In the hierarchyof evidence-based medicine, high quality RCT is still con-sidered as the golden standard for evaluating interventionaltreatment. Currently, multicenter RCTs and a prospectivecohort study have been conducted to evaluate the benefitof CAM for CVDs, and most of these researches showedpositive findings. Nevertheless, the effectiveness of CAM onthe treatment of CVDs in the real world is still unclear whichlimits the application of CAM. The reason is that efficacy ofintervention in RCT is not equal to its effectiveness in the realworld. In the future, in addition to high quality RCTs, moreevidence from real world researches is warranted to supportthe use of CAM including traditional Chinese medicine forCVDs patients.

Ke-ji ChenKa Kit Hui

Myeong Soo LeeHao Xu

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