Objectives To explore the effect of Qingre Huoxue Recipe（清热活血方） on major cardiovascular events（MACE） in patients with acute ST segment elevation myocardial infarction（STEMI） during one-year follow-up. Methods A total of 186 STEMI patients hospitalized in the First Affiliated Hospital of Guangzhou University of Chinese Medicine were included in the observation group

who were treated with standard treatment in combination with Qingre Huoxue Recipe

one dose per day; 176 contemporaneous STEMI patients admitted to six grade III Level A hospitals in five southern provinces were included in the control group

who were treated with standard treatment in accordance with Western medicine guidelines. The treatment in both groups lasted for one week. The number of MACE was recorded after one-week treatment

and during follow-up of 30 days

six months and one year after the onset of STEMI. Furthermore

the cohort was divided into high exposure group（Qingre Huoxue Recipe ≥ 30 days

153 cases）

low exposure group（Qingre Huoxue Recipe < 30 days

33 cases） and no exposure group（no Qingre Huoxue Recipe

176 cases） based on the treatment time of Qingre Huoxue Recipe

and the final number of MACE was compared between different exposure groups; the COX regression model was used to perform survival analysis

and the relation to final MACE and related factors. Results The mortality after one-week treatment in the observation group and control group was 1.1%（2/186） and 1.7%（3/176）

respectively; the one-year mortality was 2.7%（5/186） and 5.7%（10/176）

respectively（P>0.05）. The number of new or worsening heart failure after one-week treatment

as well as the hospital admission times during one-year follow up were both higher in observation group than in the control group（P<0.05）. Cox regression analysis showed that Qingre Huoxue Recipe was an independent protective factor for long-term mortality in STEMI patients（hazard ratio=0.271

95% confidence interval=0.074 to 0.997

P=0.0495）. After one-year follow-up

the mortality rate was significantly lower in high exposure group than in no exposure group（P<0.05）; the hospital admission times due to heart failure was higher（P<0.05）

while the recurrence of myocardial infarction was not significantly different between groups（P>0.05）. The mortality

recurrence of myocardial infarction

and hospitalization due to heart failure were significantly reduced in high exposure group compared to low exposure group（P<0.05）. Compared to no exposure group

the low exposure group had higher recurrence rate of myocardial infarction

and hospitalization times due to heart failure（P<0.05）

but the mortality was not significantly different（P>0.05）. Conclusion Qingre Huoxue Recipe

in addition to standard treatment in accordance with Western medicine guidelines

is an independent protective factor for long-term mortality

and can maximize the prognosis of STEMI patients.