The coronary slow-flow/no-reflow phenomenon adversely affects clinical outcomes following percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS), demonstrating a substantial association with increased cardiovascular mortality and heart failure incidence. Despite its significant clinical implications, current therapeutic strategies for this condition lack robust guideline recommendations and are not supported by large-scale clinical evidence. Intracoronary administration of recombinant human prourokinase, a novel fibrin-specific thrombolytic, demonstrates potential for improving microvascular dysfunction through targeted fibrinolysis. Nevertheless, current evidence is limited to small-scale clinical studies, lacking large-scale trials to guideline recommendations. This study aims to investigate whether selective intracoronary administration of prourokinase, in addition to conventional intensive antiplatelet therapy, nitrates and calcium channel blockers, can reduce the incidence of cardiovascular events at 12 months post-PCI in patients with ACS experiencing slow flow/no-reflow during the procedure without increasing the incidence of major bleeding events.

This study aimed to construct an evidence chain for the efficacy of Shuxuening Injection(SXN) in the treatment of unstable angina pectoris(UAP) and clarify its efficacy and underlying mechanisms. Eight major Chinese and English databases, including CNKI, VIP, Wanfang, SinoMed, PubMed, Cochrane Library, EMbase, and Web of Science, were systematically searched to collect clinical studies, animal experiments, cell experiments, and molecular experiments on SXN for UAP. Two researchers independently screened the literature and extracted data. Meta-analysis or descriptive analysis was used for data integration. The TCM evidence chain construction method was applied to establish evidence chains, which were then evaluated. A total of 2 evidence chains were constructed, incorporating 64 clinical studies, 12 animal experiments, 11 cell experiments, and 86 outcome indicators. The evidence chains elucidated the efficacy and mechanisms of SXN for UAP from 2 dimensions: improvement of myocardial ischemia and protection of cardiac function. SXN exerted a synergistic effect on the core pathological processes of UAP through multiple mechanisms, including regulating oxidative stress, promoting angiogenesis, modulating inflammation and matrix remodeling, inhibiting apoptosis, and balancing endoplasmic reticulum stress. SXN demonstrated efficacy in the treatment of UAP. However, due to the limitations in the quantity and quality of included studies, the robustness of the evidence chains was insufficient. High-quality clinical and basic research is required to further verify its core mechanisms. Additionally, it is recommended that subsequent studies include more indicators reflecting plaque stability and thrombosis in the selection of clinical outcome indicators.

This study aimed to analyze the clinical studies of TCM in treating unstable angina pectoris(UAP) in elderly patients through evidence mapping. The objective was to understand the current status and deficiencies of evidence in this field and to provide directions for future research. A systematic search was conducted across multiple databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Web of Science, and Cochrane Library, covering the period from January 1, 2005 to August 31, 2025. This search included clinical studies on TCM for the treatment of UAP in elderly patients and aimed to present the distribution characteristics of the evidence in tables and charts. Ultimately, a total of 306 randomized controlled trials(RCTs), 6 non-randomized controlled trials(non-RCTs), 4 systematic reviews, 4 observational studies, and 1 guideline were included. The research interest remained stable over the past seven years, reflecting a trend of low attention. The studies involved 54 types of Chinese patent medicines, with Danhong Injection, Salvia Miltiorrhiza Polyphenol Hydrochloride Injection, and Tongxinluo Capsules comprising the largest proportion. Most studies were single-center with small sample sizes(predominantly between 60-120 cases) and short treatment durations(mostly 2-4 weeks). Outcome indicators primarily focused on symptoms/signs and electrocardiograph(ECG), with less emphasis on prognosis, quality-of-life indicators, and TCM syndromes. The overall quality of literature for RCTs, non-RCTs, and systematic reviews/Meta-analyses was generally low, and the guideline development process lacked standardization, which resulted in an extremely low level of evidence quality. The results indicated that, despite the substantial number of clinical studies on the treatment of UAP in elderly patients with TCM, the level of evidence remained constrained by the quality of the literature. Moving forward, it is essential to conduct more large-scale, multi-center, and long-term clinical trials, standardize systematic reviews, and actively develop a core outcome indicator set that integrates the unique characteristics of TCM. These efforts are crucial for advancing the high-quality development of clinical research on TCM in the treatment of UAP in elderly patients.

Stable angina, also is known as typical angina or angina pectoris, is a symptom of myocardial ischemia. Stable angina is characterized by chest discomfort or anginal equivalent that is provoked with exertion and alleviated at rest or with nitroglycerin. This is often one of the first manifestations or warning signs of underlying coronary disease. Angina affects 10 million people in the United States (US); given this, it is important to not only recognize the signs and symptoms but also appropriately risk stratify and manage these individuals.[1]

Introduction Meteorological factors have been suggested to influence acute coronary events, but the role of temperature variability remains incompletely understood. This study aimed to evaluate the association between meteorological parameters, particularly temperature variability, and hospital admissions for acute coronary syndrome (ACS). Methods This retrospective observational ecological time-series study included 1,376 patients who were hospitalized in two cardiology centers between January 2009 and December 2010. ACS was defined as the combination of ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina pectoris (USAP). Meteorological data, including temperature and humidity parameters, were obtained from official records. Seasonal differences were analyzed, and the relationship between meteorological variables and ACS admissions was evaluated using correlation and linear regression analyses. Results A total of 981 patients were classified as having ACS. The highest number of ACS admissions was observed in May (n = 122), while the lowest occurred in September (n = 35). Total ACS admissions were similar during the cold season compared to the warm season (83.2 ± 21.3 vs. 80.3 ± 33.2, p = 0.86). In regression analysis, maximum humidity change (β = 0.122, p = 0.048), mean temperature (β = 0.813, p = 0.027), mean temperature change (β = -0.171, p = 0.025), minimum temperature change (β = 0.154, p = 0.016), and minimum humidity (β = -0.465, p = 0.014) were significantly associated with ACS admissions. Additionally, maximum temperature change (β = 0.886, p = 0.015) and daily temperature variation (β = -1.151, p = 0.004) showed significant associations with daily ACS admissions. Conclusions Although ACS admissions were numerically higher during colder periods, this difference did not reach statistical significance. Several temperature variability parameters were significantly associated with daily ACS admissions. These findings suggest that short-term fluctuations in temperature may be associated with ACS admissions, but causal relationships cannot be established because of the retrospective observational study design.