Efficacy of Yuxintong capsule on cardiorespiratory fitness in patients with stable coronary heart disease: A multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial
Clinical Snapshot
PICO Framework
| P — Population | 404 patients with stable coronary heart disease from 13 hospitals in China |
| I — Intervention | Yuxintong capsule plus conventional Western medicine for 12 weeks |
| C — Comparator | Placebo plus conventional Western medicine for 12 weeks |
| O — Outcomes | Primary: peak oxygen uptake (VO2peak) and anaerobic threshold (AT). Secondary: metabolic equivalents (METs), ECG parameters, SF-36 quality of life scores |
Bottom Line
This well-designed multicentre RCT of Yuxintong capsule in 404 patients with stable CHD showed mixed results. While the study failed to demonstrate improvement in the primary endpoint of peak oxygen uptake, there was a statistically significant but clinically modest improvement in anaerobic threshold (0.80 mL/kg/min). Quality of life measures showed some improvement in general health and vitality scores. The clinical significance of these findings is questionable, particularly given the failure to improve the primary cardiorespiratory fitness parameter. Safety profile was similar to placebo. For Australian clinicians, the evidence is insufficient to recommend this intervention, especially considering regulatory barriers and the availability of proven evidence-based therapies for stable CHD. The study provides preliminary evidence but requires replication in diverse populations with longer follow-up periods.
Key Findings
P Value: AT: p<0.025; VO2peak: not significant
Effect Size: AT improvement: 0.80 mL/kg/min difference between groups
Primary Outcome: VO2peak: no significant difference between groups; AT: significant improvement of 0.80 mL/kg/min (p<0.025)
Nnt Or Sensitivity: Number needed to treat not calculable from available data
Confidence Interval: AT: 95% CI 0.28 to 1.32 mL/kg/min
Clinical Application
Limited by availability of Yuxintong capsule outside China and uncertain regulatory approval Not TGA approved; would require individual patient importation. Limited evidence base insufficient for PBS listing consideration. RACGP guidelines do not address traditional Chinese medicines for CHD Patients with stable coronary heart disease on conventional Western therapy seeking adjunctive treatment
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE: Yuxintong capsule, a traditional Chinese patent medicine, has been widely used in the treatment of coronary heart disease (CHD). However, whether it can improve cardiopulmonary fitness (CRF) in patients with CHD remains unclear. AIM OF THE STUDY: To evaluate the efficacy and safety of Yuxintong capsule in CRF in patients with stable CHD. MATERIALS AND METHODS: A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial was conducted in 13 hospitals in China from March 2021 to November 2021, and 404 patients with stable CHD were randomly assigned to receive either Yuxintong capsule and conventional Western medicine (Yuxintong group) or placebo and conventional Western medicine (placebo group) in a 1:1 ratio for 12 weeks (ChiCTR2000041293, December 23, 2020). The primary outcomes were peak oxygen uptake (VO2peak) and anaerobic threshold (AT). The secondary outcomes were metabolic equivalents (METs), duration and onset time of 1-mm ST-segment depression on electrocardiography (ECG), and 36-Item Short Form Health Survey (SF-36) scores. The main safety indicators included complete blood count, urinalysis, liver function, renal function, coagulation function, and 12-lead electrocardiogram. And adverse events were recorded throughout the trial. RESULTS: 369 patients, 187 in the Yuxintong group and 182 in the placebo group, were finally included for analysis. Compared with placebo group, 12-week treatment with Yuxintong showed an improvement in AT (0.98 ± 2.88 vs. 0.12 ± 2.79 mL kg-1·min-1; LSMD, 0.80 [95 % CI: 0.28 to 1.32]; P < 0.025), and general health (13.61 ± 15.13 vs. 8.29 ± 14.14; LSMD 5.30, [95 % CI: 2.33 to 8.31]; P < 0.05) and vitality scores (12.46 ± 11.32 vs. 6.01 ± 11.41; LSMD 6.43, [95 % CI: 4.13 to 8.31]; P < 0.05) on SF-36 scale. The other outcomes did not significantly differ between the two groups. The adverse events were similar between the two groups. CONCLUSIONS: Yuxintong capsule, as an adjunctive therapy to conventional treatment, improved AT, and general health and vitality scores on SF-36 scale in patients with stable CHD. However, the improvements in VO2peak, METs, and the duration and onset time of 1-mm ST-segment depression on ECG were not statistically significant.
References
- 1.Zheng, L., Fu, C., Song, L., Lu, X., Jiang, H., Yu, M., Geng, A., Zhang, L., Hu, Z., Wang, L., Zheng, J., Fan, D., Wang, Z., Wu, Z., Deng, Y., Xiong, S., Zhan, P., Zhang, M., Huang, Z., Feng, L., Wang, Y., Feng, Y., Zhang, J., Xue, M., Xu, H., Shi, D., & Chen, K. (2026). Efficacy of Yuxintong capsule on cardiorespiratory fitness in patients with stable coronary heart disease: A multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial. Journal of Ethnopharmacology, 121169. https://doi.org/10.1016/j.jep.2026.121169
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