Efficacy and Safety of Shengmai Preparation Combined with Western Medicine for Coronary Heart Disease: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-27
Author(s):  
Yujuan Li ◽  
Dan Li ◽  
Xiao Jin ◽  
Shengjie Yang ◽  
Ran Zhao ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Endothelial Function ◽  
Blood Viscosity ◽  
Western Medicine ◽  
Cardiovascular Events ◽  
Platelet Reactivity ◽  
Total Mortality ◽  
Reactivity Index ◽  
Efficacy And Safety

The efficacy and safety of Shengmai preparation combined with Western medicine (SMP–WM) to treat coronary heart disease (CHD) were reviewed. Twenty-five randomized controlled trials of SMP–WM treatment for CHD were retrieved from seven databases and other trial sources between their inception and April 10, 2021. The risk of bias domains was accessed by Cochrane Collaboration’s tool, and the data were statistically analyzed using RevMan 5.3 and Stata 12.0 software. The majority of included studies had a low or unclear risk of overall bias. Total mortality was not reduced (RR = 0.39, 95% CI: 0.13–1.19, [Formula: see text] = 0.10), but the cardiovascular events (RR = 0.35, 95% CI: 0.22–0.54, [Formula: see text] < 0.01), weekly frequency (SMD = −2.38, 95% CI: −2.89 – −1.88, [Formula: see text] < 0.01), and duration (SMD = −3.24, 95% CI: −3.76 – −2.71, [Formula: see text] < 0.01) of angina pectoris attacks were significantly decreased by SMP–WM. The SMP–WM combination exerted antiplatelet activity by reducing platelet adhesion (SMD = −0.97, 95% CI: −1.49 – −0.45, [Formula: see text] = 0.0003) and the platelet reactivity index (SMD = −1.75, 95% CI: −2.04 – −1.46, [Formula: see text] < 0.01). SMP–WM could protect endothelial function by increasing nitric oxide (SMD = 1.28, 95% CI: 0.54–2.02, [Formula: see text] < 0.01) and decreasing endothelin (SMD = −1.26, 95% CI: −1.85 – −0.66, [Formula: see text] < 0.01). The combination also improved hemorheology by reducing whole blood viscosity (SMD = −1.59, 95% CI: −2.32 – −0.85, [Formula: see text] < 0.01), plasma viscosity (SMD = −0.65, 95% CI: −0.86 – −0.45, [Formula: see text] < 0.01), and fibrinogen (SMD = −4.21, 95% CI: −4.58 – −3.83, [Formula: see text] < 0.01). The SMP–WM combination favorably impacts cardiovascular events, angina symptoms, endothelial function, platelet aggregation, and blood viscosity, with comparable safety to that of routine Western medicine. Further investigation is required to enhance the strength of the evidence.

scholarly journals Efficacy and Safety of Xue-Fu-Zhu-Yu Decoction for Patients with Coronary Heart Disease: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Shuo Zhang ◽  
Zhen-Lin Chen ◽  
Yu-Ping Tang ◽  
Jin-Long Duan ◽  
Kui-Wu Yao
Keyword(s):  
Systematic Review ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Blood Viscosity ◽  
Large Scale ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Clinical Effects ◽  
Vascular Endothelial ◽  
Efficacy And Safety

Objective. To systematically evaluate the efficacy and safety of XFZYD for coronary heart disease (CHD). Methods. A comprehensive literature search of randomized controlled trials using XFZYD for CHD was conducted in 10 electronic databases from their establishment to December 20, 2020. The researchers screened the relevant trials in NoteExpress, extracted the data in duplicate independently, assessed the risk of bias in the trials using the Cochrane collaboration tool, and then used Rev Man 5.3 for data analysis. Results. 30 trials with 3126 participants were included for meta-analysis. The results showed that the clinical effects of XFZYD and its combination with chemical drugs (CD) were 1.13 (RR; 1.13; 95% CI, 1.03 to 1.24) and 1.26 (RR; 1.26; 95% CI, 1.20 to 1.32) times those of CD, respectively. And, it could also improve electrocardiogram effect, which was 1.63 (RR; 1.63; 95% CI, 1.04 to 2.53) times that of CD. XFZYD could not only decrease duration of angina pectoris and improve vascular endothelial function but also obviously reduce the TCM syndrome score. When used in combination with CD, it could also lower AF, correct the dyslipidemia, and reduce the blood viscosity. Conclusion. These results demonstrated that XFZYD had great advantages in treating CHD with no obvious adverse reactions. Therefore, it is believed that XFZYD is more suitable for CHD patients with clinical indicators of dyslipidemia, high blood viscosity, or vascular endothelial dysfunction. This study is the first systematic review and meta-analysis with some unique ways, including its comprehensiveness, large-scale search, the novelty of findings, and transparent approach.

scholarly journals Levels and Change in Galectin‐3 and Association With Cardiovascular Events: The ARIC Study

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
David Aguilar ◽  
Caroline Sun ◽  
Ron C. Hoogeveen ◽  
Vijay Nambi ◽  
Elizabeth Selvin ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Prognostic Information ◽  
Incident Coronary Heart Disease ◽  
Increased Risk ◽  
Galectin 3

Background Circulating galectin‐3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin‐3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin‐3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin‐3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996–1998; n=9247) and at ARIC visit 5 (2011–2013; n=4829). Higher galectin‐3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06–1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01–2.00), HF (HR, 1.44; 95% CI, 1.17–1.76), and mortality (HR, 1.56; 95% CI, 1.35–1.80). At visit 5 (median age, 74), higher galectin‐3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15–3.24) and total mortality (HR, 1.70; 95% CI, 1.15–2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin‐3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community‐based cohort, galectin‐3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin‐3 levels over this period was also associated with increased risk.

scholarly journals Growth Differentiation Factor 15, Its 12-Month Relative Change, and Risk of Cardiovascular Events and Total Mortality in Patients with Stable Coronary Heart Disease: 10-Year Follow-up of the KAROLA Study

2016 ◽  
Vol 62 (7) ◽  
pp. 982-992 ◽  
Author(s):  
Dhayana Dallmeier ◽  
Hermann Brenner ◽  
Ute Mons ◽  
Wolfgang Rottbauer ◽  
Wolfgang Koenig ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Events ◽  
Total Mortality ◽  
Growth Differentiation Factor 15 ◽  
Stable Coronary Heart Disease

Abstract BACKGROUND This study considered whether baseline concentrations and 12-month changes of growth differentiation factor 15 (GDF-15) are associated with subsequent cardiovascular events (CVEs) and total mortality in patients with stable coronary heart disease. METHODS Baseline GDF-15 serum concentrations were measured in 1073 participants in a cardiac rehabilitation program (median follow-up 10 years). GDF-15 associations with subsequent CVE and total mortality were evaluated by Cox-proportional hazards models adjusting for well-established cardiovascular risk factors (Model 2), plus N-terminal probrain natriuretic peptide, high-sensitivity (hs) CRP, and hs cardiac troponin T (Model 3). RESULTS In our study population [84.7% men, mean age 59 years, median baseline GDF-15 1232 ng/L (interquartile range, 916, 1674)] we observed 190 CVE and 162 deaths. Compared to participants with GDF-15 &lt;1200 ng/L, increased risk for death was found in participants with GDF-15 ≥1200 and ≤1800 ng/L [hazard ratio (HR) 1.68 (95% CI, 1.08–2.62)] and with GDF-15 &gt;1800 ng/L [HR 1.73 (1.02–2.94)], even in Model 3. The 12-month relative median change was −16.7%. As compared to participants with 12-month relative changes between −20% and 20%, GDF-15 increments &gt;20% were associated with: a) an HR of 1.84 (1.04–3.26) for CVE in Model 2, but found nonsignificant in Model 3; (b) an HR of 2.26 (1.32–3.86) for death even in Model 3. CONCLUSIONS GDF-15 at baseline is independently associated with subsequent CVE and 10-year total mortality. Twelve-month relative changes remained associated with subsequent CVE when adjusting for well-established cardiovascular risk factors, and with total mortality even after further adjustment for established cardiac biomarkers.

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