Tongxinluo (TXL), a traditional Chinese medicine (TCM) compound, improves clinical outcomes in acute myocardial infarction (AMI), acute coronary syndrome (ACS), and ischemic stroke through multi-target mechanisms including anti-inflammatory, endothelial protective, and antiplatelet effects.
Large randomized controlled trials (RCTs), such as the CTS-AMI trial, demonstrate that adjunctive TXL reduces 30-day and 1-year major adverse cardiac and cerebrovascular events (MACCEs) in ST-segment elevation myocardial infarction (STEMI) patients.
Mechanistic studies elucidate TXL’s role in preserving endothelial barrier integrity via PPAR-α and angiopoietin-like 4 pathways, modulating platelet reactivity, and enhancing mesenchymal stem cell therapy efficacy through exosomal miRNA transfer.
Clinical benefits are consistent across genetic subgroups such as CYP2C19 loss-of-function allele carriers, but gaps remain in robust evidence for long-term safety, effects in diverse populations, and specific mechanisms in different cardiovascular disease subtypes.
Background
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This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
