Blood Activating and Stasis Removing Chinese Patent Medicine in Perioperative Period of Percutaneous Coronary Intervention for Myocardial Infarction: A Protocol for a Living Clinical Practice Guideline.

Background: Myocardial infarction (MI) remains a major global health burden, with percutaneous coronary intervention (PCI) as the primary revascularization strategy. However, complications such as no-reflow, reperfusion injury and in-stent restenosis persist, requiring adjunctive therapies. Traditional Chinese Medicine (TCM), especially blood-activating and stasis-resolving Chinese patent medicine (CPM), is increasingly used in MI management. Objective: To develop a living clinical practice guideline for the perioperative use of CPMs in the perioperative period of PCI for MI, based on rigorous and transparent methodology. Methods: The guideline followed the WHO Handbook for Guideline Development, methods for developing integrated Chinese-Western medicine guidelines, and the living guideline framework. It will be reported in accordance with the RIGHT-TCM extension. Clinical questions and outcomes were framed, selected and rated through structured discussions with the Guideline Steering Committee and the Guideline Development Group. A systematic review and Bayesian network meta-analysis will evaluate the efficacy and safety of CPM. The certainty of evidence will be assessed using the GRADE approach, and recommendations will be formulated via the Evidence-to-Decision framework, incorporating benefits, harms, evidence certainty, feasibility and costs. When new clinical studies are included and critical outcomes' combined effect demonstrates directional or magnitude changes, the consensus and guideline development groups will jointly decide on new updates. Conclusion: By addressing key clinical uncertainties and leveraging real-time evidence updates, the guideline aims to enhance patient outcomes and support clinicians in decision-making.