Impact of Shexiang Baoxin Pill (MUSKARDIA) on Cardiovascular Outcomes by Baseline Hemoglobin Levels in 2, 494 Patients with Chronic Stable Coronary Artery Disease: A Secondary Subgroup Analysis

ZHOU Jing-min; SHI Hai-ming; WU Yang; JIN Yuan-zhe; WANG Sheng-huang; QIAN Jun; PAN Chao-xin; LU Feng; LI Xin-li; LI Rong; WU Keng; WANG Liu-yi; CONG Hong-liang; YANG Zhi-ming; HAO Yu-ming; YANG Peng-lin; CHEN Yan-qiu; GE Jun-bo

doi:10.1007/s11655-026-4048-5

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Impact of Shexiang Baoxin Pill (MUSKARDIA) on Cardiovascular Outcomes by Baseline Hemoglobin Levels in 2, 494 Patients with Chronic Stable Coronary Artery Disease: A Secondary Subgroup Analysis

Original Article | Updated：2026-11-13

- Impact of Shexiang Baoxin Pill (MUSKARDIA) on Cardiovascular Outcomes by Baseline Hemoglobin Levels in 2, 494 Patients with Chronic Stable Coronary Artery Disease: A Secondary Subgroup Analysis
- Chinese Journal of Integrative Medicine Vol. 32, Issue 11, Pages: 972-978(2026)
- Affiliations：
  
  Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai (200032), China
  Department of Cardiology, Huashan Hospital, Fudan University, Shanghai (200040), China
  Department of Cardiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing (100078), China
  Department of Cardiology, the Fourth Affiliated Hospital of China Medical University, Shenyang (110032), China
  Department of Cardiology, the First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang Province (315010), China
  Department of Cardiology, Ma'anshan General Hospital of Ranger-duree Healthcare, Ma'anshan, Anhui Province (243000), China
  Department of Cardiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning (530219), China
  Department of Cardiology, the Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan (250355), China
  Department of Cardiology, Jiangsu Province Hospital, Nanjing (210036), China
  Department of Cardiology, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou (510000), China
  Department of Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong Province (524000), China
  Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou (450003), China
  Department of Cardiology, Tianjin Chest Hospital, Tianjin (300000), China
  Department of Cardiology, the Second Hospital of Shanxi Medical University, Taiyuan (030000), China
  Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang (050000), China
  the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province (325000), China
  Shanghai Innovative Engineering Technology Research Center for Traditional Chinese Medicine Solid Preparations, Shanghai (200000), China
- Author bio：
  
  Correspondence to: Prof. ZHOU Jing-min, E-mail: zhou.jingmin@zs-hospital.sh.cn
- Funds：
- DOI：10.1007/s11655-026-4048-5
  CLC：
- Accepted：08 June 2026，
  
  Published：2026-11
- Accepted：
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ZHOU Jing-min, SHI Hai-ming, WU Yang, et al. Impact of Shexiang Baoxin Pill (MUSKARDIA) on Cardiovascular Outcomes by Baseline Hemoglobin Levels in 2, 494 Patients with Chronic Stable Coronary Artery Disease: A Secondary Subgroup Analysis[J]. Chinese Journal of Integrative Medicine, 2026, 32(11): 972-978.
DOI：

ZHOU Jing-min, SHI Hai-ming, WU Yang, et al. Impact of Shexiang Baoxin Pill (MUSKARDIA) on Cardiovascular Outcomes by Baseline Hemoglobin Levels in 2, 494 Patients with Chronic Stable Coronary Artery Disease: A Secondary Subgroup Analysis[J]. Chinese Journal of Integrative Medicine, 2026, 32(11): 972-978. DOI： 10.1007/s11655-026-4048-5.

摘要

Abstract

Objective: Shexiang Baoxin Pill (MUSKARDIA) reduces major adverse cardiovascular events (MACE) and improves angina

this study aims to evaluate its differential efficacy across varying hemoglobin (Hb) levels. Methods: This was a subgroup analysis of a multicenter

randomized

double-blind

placebo-controlled phase Ⅳ trial. Patients with coronary artery disease (CAD) were stratified into two groups based on baseline Hb levels: Group A (Hb 140 g/L

n=1

286) and Group B (Hb＞140 g/L

n=1

208). The primary endpoint was MACE; secondary endpoints included non-fatal myocardial infarction (MI)

non-fatal stroke

and all-cause mortality. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated using Cox proportional hazards models. Results: In Group A

MUSKARDIA significantly reduced MACE risk (HR=0.45

95% CI: 0.21-0.96

P=0.038)

with a 68% reduction in non-fatal MI risk (P=0.036). Non-fatal stroke and all-cause mortality showed no significant differences. Adverse events were lower in the MUSKARDIA group (15.9% vs. 17.6%). In Group B

no significant MACE benefit was observed (P=0.354)

with a trend toward increased non-fatal MI risk (HR=1.88). Non-fatal stroke and all-cause mortality were similar between groups. Adverse events were slightly higher (21.2% vs. 18.3%). Conclusions: MUSKARDIA demonstrated significant cardiovascular protective effects in CAD patients with Hb 140 g/L

particularly reducing non-fatal MI risk

while showing limited efficacy in patients with Hb＞140 g/L. This highlights its cardiovascular protective role in high-risk populations characterized by greater ischemic risk and inadequate myocardial oxygen supply.

关键词

Keywords

references

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