Chinese herbal medicine therapy reduces all-cause and cardiovascular disease-related mortalities in acquired hemolytic anemia: A Taiwanese nationwide retrospective cohort study

Objectives To assess whether Chinese herbal medicine (CHM) treatment was associated with all-cause and cardiovascular disease (CVD)-related mortality in Taiwanese patients with acquired hemolytic anemia (AHA). Design & setting This population-based retrospective cohort analysis used Taiwan National Health Insurance Research Database claims data covering 2008–2019. Among 6807 patients newly diagnosed with AHA from 2010 to 2017, 790 CHM and 790 non-CHM matched pairs were analyzed. Interventions CHM therapy. Main outcome measures All-cause and CVD-related mortality rates were assessed. Cox proportional hazards models estimated mortality risk, while Kaplan–Meier analysis and log-rank tests compared cumulative mortality between groups. Results The matched cohort included 790 CHM users and 790 non-users. CHM use was associated with reduced all-cause mortality (aHR, 0.63; 95% CI, 0.51–0.77; p < 0.001) and CVD-related mortality (aHR, 0.38; 95% CI, 0.21–0.69; p = 0.001). Prescription-pattern analysis identified two major CHM clusters, including a hematologic-supportive cluster centered on Huang-Qi, Dang-Gui, Gui-Pi-Tang, E-Jiao, and Dan-Shen, and a second cluster centered around Bei-Mu and Jie-Geng. Conclusions CHM therapy may lower all-cause and CVD-related mortalities in patients with AHA. The findings of this population-based retrospective cohort study provide a basis for prospective cohort or experimental studies on CHM treatment for AHA-related mortalities.