Acupuncture therapy for stable angina pectoris: a systematic review and meta-analysis

Background Stable angina pectoris (SAP) is a common cardiovascular disease, which brings health burden to society. Acupuncture therapy is effective in improving SAP as adjunctive therapy, nevertheless, there were controversies on the effect of acupuncture on disease-affected meridian (DAM), sham acupoints and nonaffected meridian (NAM). This study evaluated the effect of acupuncture on DAM as adjunctive therapy, and the difference in acupuncture on DAM, sham acupoints, and nonaffected meridian NAM. Methods Thirteen online databases were searched from inception to December 2, 2019. Risk of bias and quality of evidence for outcomes were respectively assessed by the Cochrane risk of bias assessment tool and the GRADE approach. RevMan 5.3 was adopted to conduct meta-analysis. Results Thirteen RCTs including 1026 participants were included in this study. Acupuncture therapy could be effective in the improvement of angina severity, ECG results, 6-MWT, SAQ results (physical limitation, angina stability, angina frequency, treatment satisfaction, disease perception), anxiety, HRV (LF, LF/HF), ET, CRP, and reduction of nitroglycerin intake. Acupuncture on DAM could be more beneficial than acupuncture on sham acupoints in aspects of angina severity, 6-MWT, SAQ results (angina stability, angina frequency, treatment satisfaction, disease perception). Compared to acupuncture in NAM, acupuncture on DAM could be more effective in SAQ results (angina stability, angina frequency, treatment satisfaction). Moreover, acupuncture on DAM did not increase the risk of dropout and adverse effect. Conclusions Acupuncture on DAM could effectively improving SAP, and it could be more effective compared with acupuncture on sham acupoints or NAM. However, these conclusions were limited by low-quality of most of included studies. Registration Open Science Framework registration (DOI: 10.17605/OSF.IO/F9DTW).