scholarly journals Research on Effect and Mechanism of Xuefu Zhuyu Decoction on CHD Based on Meta-Analysis and Network Pharmacology

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Fuguang Kui ◽  
Wenwen Gu ◽  
Fan Gao ◽  
Yuji Niu ◽  
Wenwen Li ◽  
...  

Xuefu Zhuyu Decoction (XFZY) is an ancient compound widely used in the treatment of coronary heart disease. However, its efficacy evaluation is not complete and its mechanism of action is not clear enough. In an attempt to address these problems, the efficacy was evaluated by meta-analysis and the mechanism was elucidated by the network pharmacology method. We systematically searched relevant studies in PubMed, Chinese National Knowledge Infrastructure Database (CNKI), Cochrane Library, Wanfang Data, and other databases from 2007 to 2019. The association between XFZY treatment and CHD was estimated by risk ratio (RR) and corresponding 95% confidence intervals (95% CIs). The compounds and the potential protein targets of XFZY were obtained from TCMSP, and active compounds were selected according to their oral bioavailability and drug similarity. The potential genes of coronary heart disease were obtained from TTD, OMIM, and GeneCards. The potential pathways related to genes were determined by GO and KEGG pathway enrichment analyses. The compound-target and compound-target-pathway networks were constructed. Molecular docking validates the component and the target. A total of 21 studies including 1844 patients were enrolled in the present meta-analysis, indicating that XFZY has a greater beneficial on total effect (fixed effect RR = 1.30; 95% Cl: 1.24–1.36; P = 0.82 ; I2 = 0.0%) and electrocardiogram efficacy (fixed effect RR = 1.40; 95% Cl: 1.26–1.56; P = 0.96 ; I2 = 0.0%) compared with the control group. A total of 1342 components in XFZY were obtained, among which, 241 were chosen as bioactive components. GO and KEGG analyses got top 10 significantly enriched terms and 10 enriched pathways. The C-T network included 192 compounds and 3085 targets, whereas the C-T-P network included 10 compounds, 109 targets, and 5 pathways. There was a good binding activity between the components and the targets. XFZY has the curative effect on coronary heart disease, and its mechanism is related to 10 compounds, 10 core targets, and 5 pathways.

2021 ◽  
pp. 106002802110098
Author(s):  
Linguang Gan ◽  
Xiaohong Zhao ◽  
Xiangjian Chen

Background: This study systematically evaluated the safety and efficacy of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population as well as whether the results met the information required to draw conclusions. Objective: To evaluate the safety and efficacy evaluation of dexmedetomidine for procedural sedation and postoperative behaviors in a pediatric population. Methods: PubMed, Cochrane library, Web of Science and Ovid MEDLINE were searched to obtain randomized controlled trials (RCTs) comparing dexmedetomidine with control medicine and comparing different doses of dexmedetomidine. Results: There were a total of 16 RCTs for a total of 3240 patients. Dexmedetomidine slowed down the heart rate (HR; mean difference: −13.27; 95% CI: −16.41 to 10.14; P < 0.001) and reduced postoperative delirium (risk ratio [RR]: 0.31; 95% CI: 0.20-0.50; P < 0.001), the number of pain patients (RR: 0.48; 95% CI: 0.30-0.75; P = 0.002), and desaturation (RR: 0.34; 95% CI: 0.13-0.89; P = 0.03) compared with the control group. The limitation was that it was difficult to determine the range of low- and high-dose dexmedetomidine. Conclusion and Relevance: Dexmedetomidine slowed down intraoperative HR within the normal range, which might reduce myocardial oxygen consumption. It reduced postoperative pain and postoperative complications: delirium and desaturation. Dexmedetomidine showed no dose-dependent increase in the procedural sedation time of pediatric patients. Clinically, dexmedetomidine can improve pediatric procedural sedation and postoperative behavior, and it can be considered as a related medicine for safety in pediatric surgery.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Donald Edmondson ◽  
Ian M Kronish ◽  
Jonathan A Shaffer ◽  
Louise Falzon ◽  
Matthew M Burg

Context: Recent evidence suggests that posttraumatic stress disorder (PTSD) may be associated with increased risk for coronary heart disease (CHD). Objective: To determine the association of PTSD to incident CHD using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, Scopus, Cochrane Library, PILOTS database, and through manual search of reference lists. Study Selection: Prospective cohort studies that assessed PTSD in participants free of CHD and assessed subsequent CHD or cardiac-specific mortality. Data Extraction: We extracted estimates of the association of PTSD to incident CHD, as well as study characteristics. Odds ratios were converted to hazard ratios (HR), and a random-effects model was used to pool results. Data Synthesis: Five studies met our inclusion criteria (N= 401,712); 4 of these included depression as a covariate. The pooled HR for the magnitude of the relationship between PTSD and CHD was 1.53 (95% CI, 1.27-1.84) before adjustment for depression. The pooled HR estimate for the 4 depression-adjusted estimates (N= 362,388) was 1.22 (95% CI, 1.05-1.42). Conclusion: PTSD is independently associated with increased risk for incident CHD, even after adjusting for depression and other covariates. Figure 1. Forest plot of association of PTSD to incident MI or cardiac mortality Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.


2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Lan-Chun Liu ◽  
Qi-Yuan Mao ◽  
Chao Liu ◽  
Jun Hu ◽  
Lian Duan ◽  
...  

Objective. The aim of this meta-analysis was to systematically evaluate the effectiveness and safety of the traditional Chinese medicine (TCM) formula Bushen Huoxue Decoction (BSHXD) in treating coronary heart disease (CHD). Methods. Randomized controlled trials (RCTS) of BSHXD in treating CHD were searched until March 2020, through six electronic databases: PubMed, Cochrane Library, CNKI, WanFang, SinoMed, and VIP. This study used the Cochrane Risk Test bias tool in the Cochrane Handbook to assess the quality of the methodology. Review Manager (RevMan) 5.3 was used to analyze the results. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria were applied in the classification of evidence quality. Results. Ten RCTs involving 901 patients were finally included in this meta-analysis. It revealed that the effectiveness of BSHXD in treating CHD was significantly better than that of the conventional western medicine (CWM) treatment ( P < 0.00001 ). The effective rate of BSHXD treatment group on ECG was also significantly higher than that of CWM group ( P < 0.00001 ). The low-density lipoprotein cholesterol was decreased in the treatment groups compared with those in the control groups ( P < 0.00001 ). There was also a reduction in frequency and duration of angina pectoris ( P < 0.00001 ). There were no significant differences in TC level ( P = 0.08 ), TG level ( P = 0.86 ), and HDL level ( P = 0.76 ) between the treatment and control groups. Five studies had informed adverse events, including nausea and diarrhea. Conclusion. Our findings laid the foundation to the use of TCM Formula BSHXD in combination with conventional western medicine for treating CHD. However, due to the limitation of the quality of the included researches, in addition to potential reporting bias, the above conclusions still need verification by higher-quality and better-designed studies.


2019 ◽  
Author(s):  
Qing-wei Cai ◽  
Lin Ren ◽  
Rui-xin Chen ◽  
Yang Zou ◽  
Qiang Fu ◽  
...  

Abstract Aims More and more research is focused on studying the relationship of periodontal disease with susceptibility to coronary heart disease (CHD), among which discrepancies have risen. The current study aimed to evaluate the possible relationship about periodontal disease and CHD in certain Chinese population. Methods The PubMed, Embase, Web of Science, the Cochrane Library, the Chinese Biomedical Database, and the Chinese National Knowledge Infrastructure were searched up to December 2018. The overall and subgroup analyses were performed using fixed or random-effect model depending on heterogeneity. Results A total of 2241 CHD cases and 2160 in 15 studies were used in the current study. Overall, a significantly elevated relationship about periodontal disease on CHD risk was found in all included Chinese subjects (OR=3.04, 95% CI, 2.37-3.92). Subgroup analyses by geographic location and sources of control were also performed; all the results in subgroup analyses were consistent with the overall result. Meanwhile, the significant association was found among the measures of periodontal disease with attachment loss, periodontal index, two or more clinical indications, and gum recession as well as CHD assessment method with WHO criteria and coronary arteriongraphy. Conclusions Collectively, the meta-analysis indicated that periodontal disease was capable of causing CHD susceptibility among Chinese.


Author(s):  
Gaohong Wu ◽  
Haifeng Geng ◽  
Yue Jiang ◽  
Wei Song ◽  
Xueping Zhu ◽  
...  

To evaluate the efficacy of fish oil for protection against coronary heart disease (CHD), we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the use of fish oil for protection against CHD. We retrieved relevant articles published from January 1966 to January 2020 by searching the PubMed, EMBASE, Cochrane CENTRAL, and Web of Science databases. RCTs of fish oil in preventing CHD were selected. The study quality was evaluated using the Cochrane Risk of Bias tool with RevMan 5.3 software. The first selection involved 350 citations. After screening and evaluation of suitability, 19 RCTs adjusted for clustering were included in the meta-analysis. All selected manuscripts considered that fish oil was effective in preventing CHD, secondary outcome measures included angina, sepsis and death. Compared with the control group, fish oil may confer significant protection against CHD (odds ratio = 0.84; 95% confidence interval: 0.72–0.98). There was no significant difference in the incidence of secondary outcomes between the observation group and the control group (P &gt; 0.05). The above results show that fish oil plays an important role in reducing CHD and cardiovascular events. However, because of the suboptimal quality of the studies included into the meta-analysis, these results do not justify adding fish oils systematically to the heavy pharmaceutical assortment already recommended in CHD patients.


2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Li Ren ◽  
Jie Wang ◽  
Ling Feng ◽  
Shuli Wang ◽  
Jun Li

Suxiao jiuxin pill is considered an effective ancillary drug in patients with coronary heart disease. Although numerous small, single-center clinical trials have been conducted, the benefits and harms of suxiao jiuxin pill remain controversial. We performed a meta-analysis to clarify the efficacy of suxiao jiuxin pill on patients with coronary heart disease. Randomized controlled trials were identified by using the Cochrane Library, PubMed, Web of Science, Embase, Wanfang, Weipu, and China Knowledge Resource Integrated databases (until June 2016). Pooled relative risks (RR), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were estimated using random-effects models. Forty-one trials involving 6276 patients were included in our analysis. Administration of suxiao jiuxin pill significantly improved electrocardiogram (ECG) results when compared with other therapies (RR 1.32, 95% CI 1.26 to 1.38, and P<0.001). Subgroup analyses revealed that suxiao jiuxin pills improve ECG results more than salvia tablets (RR 1.54, 95% CI 1.41 to 1.67, and P<0.001), isosorbide dinitrate (RR 1.14, 95% CI 1.21 to 1.44, and P=0.001), nitroglycerin (RR 1.35, 95% CI 1.16 to 1.56, and P<0.001), and other drugs (RR 1.32, 95% CI 1.21 to 1.44, and P<0.001). Available evidence additionally suggests that suxiao jiuxin pills could significantly reduce total cholesterol (WMD −0.62 mmol/L, 95% CI −1.06 to –0.18 mmol/L, and P=0.005) and low-density lipoprotein (LDL) levels (WMD −1.12 mmol/L, 95% CI −1.42 to −0.82 mmol/L, and P<0.001) and increase high-density lipoprotein (HDL) levels (WMD 0.32 mmol/L, 95% CI 0.07 to 0.58 mmol/L, and P=0.014). However, no significant differences were observed in total triglyceride levels, plasma viscosity, hematocrit, and fibrinogen. No incidences of adverse reactions were observed after administration of suxiao jiuxin pill. Improvements in ECG results and lipid profiles were also observed after suxiao jiuxin administration compared to other therapies. It also decreased low-cut and high-cut whole blood viscosity without significant adverse reactions.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Pradyumna Agasthi ◽  
Sivakanth Aloor ◽  
Avantika Chenna ◽  
Vivek Menon ◽  
Rachel Harris

Background: Chemerin is a novel adipokine linked with obesity, metabolic syndrome and chronic inflammatory diseases. It plays a pivotal role in modulating adipocyte differentiation, activation of macrophages and production of proinflammatory cytokines. It is hypothesized that chemerin promotes vascular remodeling and endothelial dysfunction leading to the development of coronary atherosclerosis. We conducted a meta-analysis to evaluate the relationship between serum chemerin levels and coronary heart disease (CHD). Methods: We searched MEDLINE, CINAHL and COCHRANE databases for studies reporting serum chemerin levels in the patients with CHD and healthy controls. We included case controls, cohort and cross-sectional studies. We calculated the weighted standardized mean difference (SMD) in serum chemerin levels between the CHD and control groups.We performed residual maximum likelihood meta-regression analysis on covariates age, BMI and female sex. Results: Our search strategy yielded 43 articles and we included 10 studies enrolling 2225 participants. The median age and body mass index(BMI) of the CHD group was 62 yrs (IQR 60-63) and 26 kg/m 2 (IQR 26-28) vs 61 yrs (IQR 58-62) and 26 kg/m 2 (IQR 24-27) in the control group. The median percentage of female population was lower in the CHD group at 39% (IQR 22-52) vs 49% (IQR 31-53) in the control group. The unweighted median serum chemerin levels in the CHD group were 33.3 ng/ml (IQR 25.4-63.2) compared to 29.8 ng/ml (IQR 15.2-38.2) in the control group. The SMD of serum chemerin level was 0.78 (95% CI 0.39 - 1.17) P <0.001 comparing those in the CHD group and control group. This association was not explained by age, BMI or sex. Conclusion: An elevated serum chemerin level is significantly associated with presence of CHD. Chemerin can potentially used as a novel biomarker and to risk stratify patients with CHD.


2021 ◽  
Vol 24 (5) ◽  
pp. E863-E867
Author(s):  
Chenchao Fu ◽  
Xin Wu

Background: The efficacy of colchicine administration for coronary heart disease remains controversial. We conducted a systematic review and meta-analysis to explore the influence of colchicine administration versus placebo on treatment efficacy for coronary heart disease. Methods: We have searched PubMed, Embase, Web of Science, EBSCO, and Cochrane Library databases through May 2021 for randomized controlled trials (RCTs) assessing the effect of colchicine administration versus placebo in patients with coronary heart disease. This meta-analysis was performed using the random-effects model. Results: Six RCTs involving 6,321 patients were included in the meta-analysis. Overall, compared with control groups for coronary heart disease, colchicine intervention can significantly reduce major adverse cardiovascular events (odds ratio [OR] 0.74; 95% confidence interval [CI] 0.59 to 0.92; P = .006), but revealed no obvious impact on mortality (OR=0.93; 95% CI=0.63 to 1.36; P = .69), serious adverse events (OR 0.71; 95% CI 0.31 to 1.61; P = .41), or restenosis (OR 1.02; 95% CI 0.63 to 1.64; P = .95). Conclusions: Colchicine treatment may be effective to reduce major adverse cardiovascular events in patients with coronary heart disease.


2020 ◽  
Vol 98 (3) ◽  
pp. 231-235
Author(s):  
N. Yu. Borovkova ◽  
M. V. Buyanova ◽  
T. E. Bakka ◽  
M. P. Nistratova ◽  
T. V. Vlasova ◽  
...  

To evaluate possibilities of aspirin-induced gastroduodenopathy treatment in the patients with chronic ischemic heart disease by means of applying the internal endogenous prostaglandins stimulant.  Material and methods. 340 patients suffering from chronic coronary heart disease and receiving a long-term acetylsalicylic acid (ASA) therapy were examined on the base of the cardiovascular care unit of The Nizhny Novgorod Regional Clinical Hospital named after N.A. Semaschko. There were evaluated frequency, nature and severity of the aspirin-induced gastroduodenopathy. The patients with coronary heart disease and aspirin-induced gastroduodenopathy were divided in two groups. In the first group of patients there was applied rebamipide therapy (in a single daily dose 300 mg) in combination with the proton pump inhibitor (PPI) — pantoprazole. In the second group there was applied only pantoprazole therapy. For the purpose of specification of AIG pathogenetic mechanisms development, all the examined chronic coronary heart disease cases were tested on the prostaglandin E2 (PGE2) level in blood serum before the therapy beginning and after the treatment. The control group was formed of chronic coronary heart disease patients showing no AIG evidence. Statistical processing of the received data was fulfilled with the program «Statistika 10.0». Results. AIG was registered in 15% out of 340 chronic coronary heart disease patients. According to the endoscopic examination erosive disease of the body and antrum prevailed among the patients. The PGE2 level in the blood serum was significantly lower (р = 0,00087) in these patients in comparison with the control group. In association with PPI and rebamipide mixed therapy, esophagogastroduodenoscopy results showed no pathological findings in gastrointestinal mucosa and statistically significant (р = 0,00067) blood serum PGE2 level growing in all the treated patients. As a result of exclusive PPI therapy there was marked positive dynamics in endoscopic view in 19 out of 25 patients and a tendency to normalization of PGE2 level in the blood serum. However, PGE2 level growing was insignificant. Conclusion. The presented research demonstrates the possibility of AIG treatment with the use of internal endogenous prostaglandins stimulant — rebamipide in complex with proton pump inhibitor PPI therapy.


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