Traditional Chinese medicine combined with conventional treatment for the patients after percutaneous coronary intervention: A systematic review and meta-analysis

Abstract

Purpose: To evaluate the efficacy, quality of care and safety of Traditional Chinese Medicine (TCM) after Percutaneous Coronary Intervention (PCI). using systematic review and meta-analysis of randomized controlled trials.Methods: Relevant studies published between January 1st 2010 and August 20th, 2021, on traditional Chinese medicine (TCM) and conventional treatment (CT) after PCI were sourced from different databases including CNKI, CBM, Web of Science, PubMed, Embase and Cochrane library. The TCM was composed of preparations of chinese eaglewood, peppermint, radix notoginseng, scabrous elephant foot herb, Tongxinluo, Danhong, Naoxintong capsule, Huxin Formula and liquorice root while the CT included aspirin (100 mg/day), clopidogrel (75 mg/day), and statins. PRISMA guidelines were used. Primary outcome was to evaluate the efficacy, quality of care and safety of TCM versus conventional treatment post percutaneous coronary intervention (PCI).Results: 110 randomized controlled trials (RCTs) were retrieved and analyzed. The results from metaanalysis showed an enhanced left ventricular ejection fraction (LVEF) % among patients that received TCM compared to those on CT [mean difference ± sd (MD)=5.17, 95% CI (3.29-7.06), Z = 5.38, (P < 0.001)]. Further, hypersensitive C-reactive protein (HS-CRP) level in TCM group was found to be relatively lower than that of the CT group (CG) [MD=-1.44, 95% CI (-2.87-0.00), Z=1.96, (P=0.05)]. In terms of safety, TCM group relative risk score in fixed-effect model was lower than that of the CG [RR=0.66, 95% CI (0.40, 1.10), Z=1.66,].Conclusion: It can be inferred from the results that TCM has more advantages in terms of clinical efficacy, quality of care and safety compared to conventional therapy. However, the lack of substantial research in deploying TCM for the treatment of CHD demands further exploration and strong evidence prior to clinical application of TCM.