Chinese Herbal Medicine Qiliqiangxin Cuts Heart Failure Hospitalization and Cardiovascular Death by 22%, Trial of 3,110 Finds

Results of a large randomized trial published in Nature Medicine show that adding Qiliqiangxin (QLQX), a Chinese herbal capsule used for heart failure, to standard treatment reduced hospitalizations and cardiovascular deaths. This is the QUEST trial, led by the First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), with 133 hospitals in China taking part.

Median 18.3 Months, Hazard Ratio 0.78

The participants were 3,110 patients with heart failure with reduced ejection fraction (HFrEF), with a left ventricular ejection fraction of 40% or lower and NT-proBNP, a heart failure marker, of 450 pg/mL or higher. While continuing their existing heart failure treatment, they took either Qiliqiangxin or placebo, 4 capsules at a time, three times a day. The primary outcome, a composite of heart failure hospitalization or cardiovascular death, occurred in 25.02% of the Qiliqiangxin group and 30.03% of the placebo group (hazard ratio 0.78). Heart failure hospitalization (15.63% vs. 19.16%) and cardiovascular death (13.31% vs. 15.95%) were each lower in the Qiliqiangxin group as well.

On the other hand, there was no statistically significant difference in all-cause death between the two groups (hazard ratio 0.84), and adverse events occurred at similar rates.

Because all participants were Chinese patients, the results cannot be applied directly to other populations. The treatment is a compound formula mixing several herbs, so the active ingredients cannot be identified, and some of the authors disclosed ties to related companies. The abstract does not state the clinical trial phase.