Adjunctive Acupuncture therapy may reduce angina attacks in chronic Stable Angina: JAMA

Adjunctive Acupuncture therapy may reduce frequency of angina attacks in chronic Stable Angina, finds a new study.

Acupuncture, if done on the acupoints in the disease affected meridian has the potential to be used as an adjunctive therapy which may help in the reduction of chronic stable angina with 16 weeks of the intervention, revealed a study published in JAMA

Acupuncture is an age-old nonpharmacologic treatment performed especially to relieve symptoms of myocardial ischemia, improve cardiac function, and prevent a recurrence. Treatment involves inserting very thin needles through a person's skin at specific points on the body, to various depths. Acupuncture's protective effect against cardiac ischemia and angina has been proved by many animal studies and small studies. However, the effects of acupuncture as adjunctive treatment to antianginal therapies for patients with chronic stable angina has not been investigated in depth.

The study was aimed at ascertaining the efficacy and safety of acupuncture adjunctive therapy to antianginal therapies in reducing the frequency of angina attacks.

This randomized clinical trial that included 404 patients with chronic stable angina found that acupuncture on the acupoints in the disease-affected meridian significantly reduced the frequency of angina attacks compared with acupuncture on the acupoints on the nonaffected meridian, sham acupuncture, and no acupuncture. Adjunctive therapy with acupuncture had a significant effect on relieving angina within 16 weeks.

In this 20-week randomized clinical trial conducted in outpatient and inpatient settings at 5 clinical centers in China from October 10, 2012, to September 19, 2015, 404 participants were randomly assigned to receive acupuncture on the acupoints on the disease-affected meridian (DAM), receive acupuncture on the acupoints on the nonaffected meridian (NAM), receive sham acupuncture (SA), and receive no acupuncture (waitlist [WL] group). Participants were 35 to 80 years of age with chronic stable angina based on the criteria of the American College of Cardiology and the American Heart Association, with angina occurring at least twice weekly. Statistical analysis was conducted from December 1, 2015, to July 30, 2016.

All participants in the 4 groups received antianginal therapies as recommended by the guidelines. Participants in the DAM, NAM, and SA groups received acupuncture treatment 3 times weekly for 4 weeks for a total of 12 sessions. Participants in the WL group did not receive acupuncture during the 16-week study period.

Participants used diaries to record angina attacks. The primary outcome was the change in the frequency of angina attacks every 4 weeks from baseline to week 16. The study included a total of 398 participants (253 women and 145 men aged around 60 years). Baseline characteristics were comparable across the 4 groups.

Main findings

Mean changes in the frequency of angina attacks differed significantly among the 4 groups at 16 weeks: a greater reduction of angina attacks was observed in the DAM group vs the NAM group.

A greater reduction of angina attacks was observed in the DAM group vs the SA group.

In the DAM group vs the WL group, a greater reduction of angina attacks was observed in the DAM group.

"Compared with acupuncture on the NAM, SA, or no acupuncture (WL), acupuncture on the DAM as adjunctive treatment to antianginal therapy showed superior benefits in alleviating angina." concluded the authors.

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doi:10.1001/jamainternmed.2019.2407