# Effects of ginseng berry saponins on cardiorespiratory fitness in patients with SCAD: a randomized, double-blinded, placebo-controlled trial

## TL;DR

A study found that Zhenyuan Capsule, made from ginseng berry saponins, improves cardiorespiratory fitness in patients with stable coronary artery disease.

## Contribution

This is the first randomized, placebo-controlled trial showing Zhenyuan Capsule's effect on CRF and identifying IGF2 as a potential molecular candidate.

## Key findings

- Zhenyuan Capsule significantly improved metabolic equivalents at anaerobic and maximal levels compared to placebo.
- IGF2 was downregulated in some responders, possibly linked to cholesterol metabolism and the PI3K-Akt pathway.
- No serious adverse events were reported in either group during the trial.

## Abstract

With the development of cardiac rehabilitation (CR), the advantages of combined Chinese and Western medicine cardiac rehabilitation for the treatment of stable coronary artery disease (SCAD) have become increasingly prominent.

This study was aimed to evaluate the effect of Zhenyuan capsule (a Chinese patented medicine consisting of ginseng berry saponins extracted from the mature berry of Panax Ginseng) on cardiorespiratory fitness (CRF) in patients with SCAD, and explore possible potential candidate molecule.

Using a randomized, double-blind, placebo-controlled trial design, 100 patients with SCAD were enrolled and randomly divided into the group taking Zhenyuan capsules (test group, n = 50) and the group taking placebo (control group, n = 50). In both groups, patients were treated with secondary prevention medication for CHD, with the addition of 2 capsules of Zhenyuan capsule 3 times a day for 12 weeks in the test group and 2 capsules of placebo 3 times a day for 12 weeks in the control group, with a follow-up of 1 month after the end of treatment. Subjects completed symptom-limited maximal cardiopulmonary exercise test (CPET) on a bicycle ergometer at 3 time points before enrollment, after 12 weeks of treatment, and after 1 month of follow-up. The main outcome was the increase in metabolic equivalent.

Both at anaerobic threshold (AT) level and at maximal level, the results of between-group comparisons showed that the test group was significantly better than that of the control group after treatment (AT level: 0.58 ± 0.89 Mets vs. 0.15 ± 1.06 Mets; maximal level: 0.69 ± 0.92 Mets vs. 0.19 ± 0.93 Mets) (P < 0.05). No serious adverse events occurred in patients in both groups. Serum proteomics studies suggested that insulin-like growth factor II (IGF2) was downregulated in a minority of responders, potentially related to cholesterol metabolism and the PI3K-Akt pathway.

Zhenyuan capsule can significantly improve the CRF of patients with SCAD, and the downregulation of IGF2 observed in a minority of responders suggests IGF2 may be a potential candidate molecule of interest associated with cholesterol metabolism and the PI3K-Akt pathway.

https://www.chictr.org.cn/showproj.html?proj=53361, identifier ChiCTR2000032818.

Study design and outcomes for a trial on SCAD patients show Zhenyuan Capsule vs. placebo effects. Design involves CPET testing at intervals. Outcomes include bar graphs and plots indicating mean changes and pathway enrichment data. The study suggests Zhenyuan Capsule improves cardiorespiratory fitness and highlights IGF2’s potential role in cholesterol metabolism and the PI3K-Akt pathway. Abbreviations noted for context.