Objective

2

To evaluate the impact of

yang

-reinforcing and blood-activating therapy on the long-term prognosis for patients with dilated cardiomyopathy （DCM） of

yang

deficiency and blood stasis syndrome.

Methods

2

A retrospective cohort study was conducted involving 371 DCM patients with

yang

deficiency and blood stasis syndrome. The

yang

-reinforcing and blood-activating therapy was defined as the exposure factor. Patients were categorized into exposure group （186 cases） and non-exposure group （185 cases） according to whether they received

yang

-reinforcing and blood-activating therapy combined with conventional western medicine for 6 months or longer. The follow-up period was set at 48 months， and the Kaplan-Meier survival analysis was used to assess the cumulative incidenc

e of major adverse cardiovascular events （MACE） in both groups. Cox regression analysis was used to explore the impact of

yang

-reinforcing and blood-activating therapy on the risk of MACE， and subgroup analysis was performed. Changes in traditional Chinese medicine （TCM） syndrome score， left ventricular ejection fraction （LVEF）， left ventricular fractional shortening （LVFS）， left ventricular end-diastolic diameter （LVEDD）， and Minnesota Living with Heart Failure Questionnaire （MLHFQ） score were compared between groups at the time of first combined use of

yang

-reinforcing and blood-activating therapy （before treatment） and 1 year after receiving the therapy （after treatment）.

Results

2

MACE occurred in 31 cases （16.67%） in the exposure group and 47 cases （25.41%） in the non-exposure group. The cumulative incidence of MACE in the exposure group was significantly lower than that in the non-exposure group ［

HR

=0.559， 95%

CI

（0.361，0.895），

P

=0.014］. Cox regression analysis showed that

yang

-reinforcing and blood-activating therapy was an independent factor for reducing the risk of MACE in DCM patients ［

HR

=0.623， 95%

CI

（0.396，0.980），

P

=0.041］， and consistent results were observed in different subgroups. Compared with pre-treatment， the exposure group showed decreased TCM syndrome score and MLHFQ score， reduced LVEDD， and increased LVEF and LVFS after treatment （

P

＜0.05）； in the non-exposure group， TCM syndrome score decreased， LVEF and LVFS increased， and LVEDD reduced after treatment （

P

＜0.05）. After treatment， the exposure group had higher LVEF and LVFS， smaller LVEDD， and lower TCM syndrome score and MLHFQ score compared with the non-exposure group （

P

＜0.05）.

Conclusion

2

Combining

yang

-reinforcing and blood-activating therapy with conventional weste

rn medicine can reduce the risk of MACE in DCM patients with

yang

deficiency and blood stasis syndrome， meanwhile improving their clinical symptoms， cardiac function， and quality of life.