{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T19:23:15Z","timestamp":1754162595592,"version":"3.41.2"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T00:00:00Z","timestamp":1753833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Shenxiong-Xinmaikang Decoction (SXXMKD), a modified traditional Chinese herbal formula, is widely used in clinical practice for stable angina pectoris (SAP). However, robust clinical evidence supporting its efficacy and safety is lacking. This study aimed to evaluate the real-world effectiveness and safety of SXXMKD as an adjunct to standard therapy for SAP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, single-center, real-world observational study conducted between 2019 and 2023, enrolling 219 SAP patients (Registry: ChiCTR2100052872). Patients received either standard care alone (standard biomedical treatment group, SBMT group; <jats:italic>n<\/jats:italic> = 101) or SXXMKD combined with standard care (combined Traditional Chinese Medicine, CTCM group; <jats:italic>n<\/jats:italic> = 118). To minimize selection bias and balance baseline covariates, we applied inverse probability of treatment weighting (IPTW). Clinical outcomes were assessed at short- and long-term follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After IPTW adjustment, baseline characteristics were well-balanced between the groups. Compared to the SBMT group, the CTCM group demonstrated significant improvements in angina symptom scores, electrocardiogram readings, and left ventricular ejection fraction (LVEF). Furthermore, the CTCM group showed lower levels of low-density lipoprotein cholesterol (LDL-C), creatine kinase (CK), high-sensitivity C-reactive protein (hs-CRP), and cardiac troponin I (cTnI). While the incidence of cardiovascular events was reduced in the CTCM group, the difference in cardiovascular event-free survival did not reach statistical significance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a real-world setting, the addition of SXXMKD to standard biomedical treatment for SAP was safe and associated with improved symptomatic, functional, and biochemical outcomes. These findings suggest that SXXMKD is a promising adjunctive treatment for improving clinical outcomes in patients with stable angina.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn\/<\/jats:ext-link>, identifier: ChiCTR2100052872.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1591959","type":"journal-article","created":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:40:58Z","timestamp":1753868458000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of Shenxiong-Xinmaikang Decoction in patients with stable angina pectoris: a real-world prospective observational study"],"prefix":"10.3389","volume":"16","author":[{"given":"Yanchen","family":"Dong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaojuan","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongzhen","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guoping","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donghui","family":"Liang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,30]]},"reference":[{"key":"B1","first-page":"265","volume-title":"Guideline for primary care of stable coronary artery disease(2020)","author":"Association","year":"2021"},{"key":"B2","doi-asserted-by":"publisher","first-page":"541","DOI":"10.3969\/j.issn.1004-8812.2017.10.001","article-title":"Expert consensus on stable noninvasive imaging pathways for coronary heart disease","volume":"25","year":"2017","journal-title":"Chin. J. Interventional Cardiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1016\/j.ijcard.2005.10.026","article-title":"Danshen: a versatile Chinese herbal drug for the treatment of coronary heart disease","volume":"113","author":"Cheng","year":"2006","journal-title":"Int. J. Cardiol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"86","DOI":"10.36468\/pharmaceutical-sciences.1404","article-title":"Mechanism of Shenxiong-Xinmaikang decoction in treating stable Angina pectoris based on network pharmacology and molecular docking","volume":"86","author":"Dong","year":"2024","journal-title":"Indian J. Pharm. Sci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.3390\/ijms20061463","article-title":"A systematic review of phytochemistry, pharmacology and pharmacokinetics on Astragali Radix: implications for Astragali Radix as a personalized medicine","volume":"20","author":"Guo","year":"2019","journal-title":"Int. J. Mol. Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.chmed.2020.03.002","article-title":"Pharmaceutical resource discovery from traditional medicinal plants: Pharmacophylogeny and pharmacophylogenomics","volume":"12","author":"Hao","year":"2020","journal-title":"Chin. Herb. Med."},{"key":"B7","doi-asserted-by":"publisher","first-page":"953205","DOI":"10.3389\/fphar.2022.953205","article-title":"Best practice in the chemical characterisation of extracts used in pharmacological and toxicological research-the ConPhyMP-guidelines","volume":"13","author":"Heinrich","year":"2022","journal-title":"Front. Pharmacol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1001\/jama.2021.1527","article-title":"Diagnosis and management of stable angina: a review","volume":"325","author":"Joshi","year":"2021","journal-title":"JAMA"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e123","DOI":"10.1161\/CIR.0000000000000404","article-title":"2016 ACC\/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American college of Cardiology\/American Heart Association task force on clinical practice guidelines: an update of the 2011 ACCF\/AHA\/SCAI Guideline for percutaneous coronary intervention, 2011 ACCF\/AHA Guideline for coronary artery bypass graft surgery, 2012 ACC\/AHA\/ACP\/AATS\/PCNA\/SCAI\/STS Guideline for the diagnosis and management of patients with stable ischemic Heart disease, 2013 ACCF\/AHA Guideline for the management of ST-Elevation myocardial infarction, 2014 AHA\/ACC Guideline for the management of patients with Non-ST-Elevation acute coronary syndromes, and 2014 ACC\/AHA Guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery","volume":"134","author":"Levine","year":"2016","journal-title":"Circulation"},{"key":"B10","doi-asserted-by":"publisher","first-page":"e0275566","DOI":"10.1371\/journal.pone.0275566","article-title":"Identification and characterization of miRNAome and target genes in Pseudostellaria heterophylla","volume":"17","author":"Li","year":"","journal-title":"PLoS One"},{"key":"B11","doi-asserted-by":"publisher","first-page":"859956","DOI":"10.3389\/fcvm.2022.859956","article-title":"A randomized controlled trial on the efficacy of Xinnaoning capsule in the treatment of CSAP complicated with Qi stagnation and blood stasis syndrome","volume":"9","author":"Li","year":"","journal-title":"Front. Cardiovasc Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1038\/s41392-021-00741-x","article-title":"Detection of an anti-angina therapeutic module in the effective population treated by a multi-target drug Danhong injection: a randomized trial","volume":"6","author":"Liu","year":"2021","journal-title":"Signal Transduct. Target Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"3881","DOI":"10.1002\/ehf2.12980","article-title":"Qishen Yiqi dripping pills for chronic ischaemic heart failure: results of the CACT-IHF randomized clinical trial","volume":"7","author":"Mao","year":"2020","journal-title":"Esc. Heart Fail"},{"key":"B14","doi-asserted-by":"publisher","first-page":"70","DOI":"10.1186\/1471-2172-9-70","article-title":"Interleukin-1beta and tumour necrosis factor-alpha impede neutral lipid turnover in macrophage-derived foam cells","volume":"9","author":"Persson","year":"2008","journal-title":"BMC Immunol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2949","DOI":"10.1093\/eurheartj\/eht296","article-title":"2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology","volume":"34","author":"Task Force","year":"2013","journal-title":"Eur. Heart J."},{"key":"B16","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1007\/s11883-014-0422-4","article-title":"Stable angina pectoris","volume":"16","author":"Valgimigli","year":"2014","journal-title":"Curr. Atheroscler. Rep."},{"key":"B17","doi-asserted-by":"publisher","first-page":"998","DOI":"10.3332\/ecancer.2020.998","article-title":"Highlights from the 2019 International Aspirin Foundation Scientific Conference, Rome, 28 June 2019: benefits and risks of antithrombotic therapy for cardiovascular disease prevention","volume":"14","author":"Walker","year":"2020","journal-title":"Ecancermedicalscience"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1652","DOI":"10.19540\/j.cnki.cjcmm.20220907.503","article-title":"Network Meta-analysis of Chinese medicine injection combined with conventional western medicine in treatment of stable angina pectoris","volume":"48","author":"Wang","year":"2023","journal-title":"Zhongguo Zhong Yao Za Zhi"},{"key":"B19","doi-asserted-by":"publisher","first-page":"929020","DOI":"10.3389\/fcvm.2022.929020","article-title":"Associations between statins and adverse events in secondary prevention of cardiovascular disease: pairwise, network, and dose-response meta-analyses of 47 randomized controlled trials","volume":"9","author":"Wang","year":"2022","journal-title":"Front. Cardiovasc Med."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1001\/jama.2023.19524","article-title":"Traditional Chinese medicine compound (Tongxinluo) and clinical outcomes of patients with acute myocardial infarction: the CTS-AMI randomized clinical trial","volume":"330","author":"Yang","year":"2023","journal-title":"JAMA"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2212","DOI":"10.3969\/j.issn.1000-484X.2021.18.007","article-title":"Puerarin stabilizes AS vulnerable plaques by inhibiting ox-LDL induced macrophage pyroptosis pathway activation","volume":"37","author":"Zhang","year":"2021","journal-title":"Chin. J. Immunol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1002\/iub.1966","article-title":"Circulating oxidized low-density lipoprotein is a strong risk factor for the early stage of coronary heart disease","volume":"71","author":"Zhang","year":"2019","journal-title":"IUBMB Life"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1591959\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T09:41:01Z","timestamp":1753868461000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2025.1591959\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,30]]},"references-count":22,"alternative-id":["10.3389\/fphar.2025.1591959"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2025.1591959","relation":{},"ISSN":["1663-9812"],"issn-type":[{"type":"electronic","value":"1663-9812"}],"subject":[],"published":{"date-parts":[[2025,7,30]]},"article-number":"1591959"}}