Comparative efficacy of Chinese herbal injections for angina pectoris: A Bayesian network meta-analysis of randomized controlled trials

Wang, Kaihuan; Wu, Jiarui; Duan, Xiaojiao; Zhang, Dan; Lin, Xiaola; Zhang, Sixuan; Ni, Mengwei; Meng, Ziqi; Gao, Xiaoyan; Tan, Peng; Liu, Yonggang

doi:10.1016/j.ctim.2019.01.019

Cited by 8 publications

(6 citation statements)

References 8 publications

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“…A fewer side effects [23,24] of these drugs could promote postischemic angiogenesis to recovery the cerebral blood flow and tissue perfusion, supporting the survival of neurons and neural progenitor cells and promoting long-term functional recovery [25,26]. Huangqi-Honghua (HH), a common reinforcing Qi and activating blood drugs team, has been used widely in clinical practice for treating Qi deficiency and blood stasis syndrome, especially, CI with Qi deficiency and blood stasis [7,27]. Based on the available data, there are 276 compounds found in HH and categorized into flavonoids, lignans, terpene, sterols, triterpenoids, and their glycosides.…”

Section: Discussionmentioning

confidence: 99%

A Network Pharmacology Approach to Predict the Proangiogenesis Mechanism of Huangqi-Honghua Herb Pair after Cerebral Ischemia

Cao

Lü

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. Huangqi-Honghua herb pair is known for its medicinal value to treat Qi deficiency and blood stasis syndrome with a long history in clinical practice. To understand its possible mechanism in a systematic study, a network pharmacological method was addressed. Methods. Detailed information on the HH compounds was obtained from two public databases, and oral bioavailability (OB) and drug-like (DL) of the compounds were evaluated. A correlation between HH compounds, its potential targets, and known targets was extrapolated, and the herb-compound-target-disease (H-C-T-D) network was established. Next, the pathway enrichment and essential genes were analyzed. Then, three key genes (VEGFA, VEGFR2, and eNOS), highly associated with angiogenesis, were screened and verified through western blot assay. Results. Out of 276 compounds, 21 HH compounds and 78 target genes regulating the major pathways associated with CI in the network are analyzed. The bioactive compounds in HH were active in various signal transduction pathways such as the toll-like receptor signaling pathway, VEGF signaling pathway, TNF signaling pathway, and HIF-1 signaling pathway are important pathways that may regulate anti-inflammatory, antiapoptotic, immune correlation, and antioxidative effects. The core genes are PTGS2, TNF, NOS2, IL6, BCL2, IL1B, SOD2, NOS3, SOD1, MMP9, and VEGFA. The in vitro results suggested that HH treatment could significantly elevate the expression of proangiogenic genes such as VEGFA, VEGFR2, and eNOS compared with OGD groups. Conclusions. Our results predict that HH may regulate the expression of VEGFA, VEGFR2, and eNOS via the VEGF and HIF-1 signaling pathway to promote angiogenesis and alleviate cerebral ischemia injury.

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Section: Discussionmentioning

confidence: 99%

A Network Pharmacology Approach to Predict the Proangiogenesis Mechanism of Huangqi-Honghua Herb Pair after Cerebral Ischemia

Cao

Lü

Wang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Our study was impartial, valid and reliable in compliant with the pre-speci ed protocol [24,25]. Previous network meta-analyses [19,20] without protocols did not identify the limitations which included PRISMAdiscrepancy, inappropriate model selection based on heterogeneity test, inadequate statistical analysis, and lack of evidence assessment (Supplement 12). Therefore, their results and conclusions [19,20] were biased and untrustworthy.…”

Section: Discussionmentioning

confidence: 83%

“…Previous network meta-analyses [19,20] without protocols did not identify the limitations which included PRISMAdiscrepancy, inappropriate model selection based on heterogeneity test, inadequate statistical analysis, and lack of evidence assessment (Supplement 12). Therefore, their results and conclusions [19,20] were biased and untrustworthy. Our study conducted a rigorous and comprehensive network meta-analysis in accordance with the PRISMA statements [21][22][23] and the pre-speci ed protocol [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…Making healthcare decisions was complicated, not only depending on the e cacy of treatments. It was insu cient to recommend optimal treatments according to the ranking of comparative e cacy in previous network meta-analyses [19,20]. Decision-makers not only considered the overall trade-off between the e cacy and safety of interventions but also were in uenced by the certainty of evidence.…”

Section: Discussionmentioning

confidence: 99%

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Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

Gao

Leung

Jia

2020

Preprint

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Background: The efficacy of traditional Chinese medicine injections (TCMIs) for angina pectoris has never been well investigated for lacking quality assessment of evidence. This study aimed to conduct a comprehensive and rigorous network meta-analysis and assess the quality of evidence according to the Grading of Recommendations and Assessment, Development, and Evaluation (GRADE) approach to compare the efficacy of all TCMIs in treating angina pectoris.Methods: Following the protocol (reference: CRD42018117720), randomized controlled trials (RCTs) which compared one TCMI with another TCMI or conventional treatments on anginal outcome measures (i.e. symptomatic improvement, electrocardiography improvement, symptomatic recovery, and electrocardiography recovery) were included. The risk of bias among included RCTs was assessed with the revised Cochrane’s risk of bias tool 2. Frequentist statistical analyses including subgroup analysis, sensitivity analysis, meta-regression and publication bias analysis were performed. The certainty of evidence was assessed with the GRADE approach.Results: Totally, 475 RCTs including all 24 TCMIs were identified, while the quality of all but two included RCTs was poor. According to the network meta-analysis, Honghua (Safflower) injection were preferable both in improving symptoms and electrocardiography. However, significant inconsistency showed the intransitivity among indirect comparisons, results in network meta-analysis seemed thus not trustworthy. The quality of evidence was assessed as low or very low.Conclusions: The low-quality evidence reduced the confidence in the efficacious results. Current evidence hardly supports the beneficial effects of TCMIs in treating angina pectoris.

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“…[ 2 – 4 ] According to a report released in 2017 by the International Cooperation Study on the Global Burden of Disease, CHD is the leading cause of death in all diseases globally, with an estimated 110 million people suffered from CHD and 8.92 million deaths due to CHD, and the prevalence continues to rise. [ 1 , 5 ] Evidence-based medicine and a large number of clinical epidemiological investigations show that hypercholesterolemia and hypertension (HTN) are risk factors for CHD angina pectoris. [ 6 ] Hypercholesterolemia has resulted in 4 million deaths and a disability-adjusted life loss of up to 88.7 million people globally.…”

Section: Introductionmentioning

confidence: 99%

Effect of hypercholesterolemia alone or combined with hypertension on the degree of coronary artery stenosis in patients with coronary heart disease angina pectoris

et al. 2020

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Background: Coronary heart disease (CHD) is the leading cause of death globally. Angina pectoris is closely associated with coronary artery insufficiency, which seriously affects the quality of life and work of patients. Hypercholesterolemia and hypertension (HTN) are risk factors for CHD angina pectoris. The correlation between hypercholesterolemia with or without HTN and the severity of coronary arteries has not been clarified. Objective: To explore the correlation between hypercholesterolemia and the degree of coronary artery stenosis (CAS) of CHD angina pectoris, and to further research the influence of HTN on total cholesterol level and CAS, so as to provide guidance for clinical prevention and treatment. Methods: A multicenter, retrospective clinical study was conducted in the medical records management system of 6 hospitals in Tianjin. Patients who were suffered from CHD angina pectoris and aged from 35 to 75 years old are involved. They hospitalized in the Department of Cardiology between September 1, 2014, and September 1, 2019, and underwent coronary angiography. We divide patients into 3 groups based on the total cholesterol level, the degree of CAS is evaluated by Gensini score, and further divide them into 6 subgroups based on with or without HTN. Collect and analyze the demographics, laboratory information, clinical outcome data, and coronary angiographic data of patients. Conclusion: Through clinical research data, the study will help to provide guidance for the prevention and treatment of CHD angina pectoris complicated with diseases and promote further research.

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Comparative efficacy of Chinese herbal injections for angina pectoris: A Bayesian network meta-analysis of randomized controlled trials

Cited by 8 publications

References 8 publications

A Network Pharmacology Approach to Predict the Proangiogenesis Mechanism of Huangqi-Honghua Herb Pair after Cerebral Ischemia

A Network Pharmacology Approach to Predict the Proangiogenesis Mechanism of Huangqi-Honghua Herb Pair after Cerebral Ischemia

Were Traditional Chinese Medicine Injections Efficacious for Angina Pectoris? A Frequentist Network Meta-Analysis of Randomized Controlled Trials

Effect of hypercholesterolemia alone or combined with hypertension on the degree of coronary artery stenosis in patients with coronary heart disease angina pectoris

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