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Purpose To investigate effects of PNS and its activity components in the mouse model of tumor complicated with myocardial ischemia.Methods Tumor complexed with myocardial ischemia mouse model was first established, which was followed by histological and immunohistochemistry examination to assess the effect of indicated treatments on tumor,myocardial ischemia and tissue specific angiogenesis.MicroRNA (miRNA) profiling was further carried out to identify potential miRNA regulators that might mechanistically underline the therapeutic effects of PNS in this complex model.Results PNS and its major activity components Rg1, Rb1 and R1 suppressed tumor growth and simultaneously attenuated myocardial ischemia.PNS treatment led to decreased expression of CD34 and vWF in tumor and increased expression of these vascular markers in heart PNS treatment resulted in reduced expression ofmiR-18a in tumor and upregulated expression ofmiR-18a in heart.Conclusions Our data demonstrated for the first time that PNS exerts tissue specific regulatory effects on angiogenesis in part through modulating the expression of miR-18a, which could be responsible for its bidirectional effect on complex disease conditions where paradoxical angiogenesis is implicated.Therefore, our study provides experimental evidence warranting evaluation of PNS and related bioactive component as a rational therapy for complex disease conditions including co-manifestation of cancer and ischemic cardiovascular disease.