The comparative effects of oral Chinese patent medicines combined with western medicine in stable angina: A systematic review and network meta-analysis of 179 trials

Huang, Peiying; Li, Zhishang; Chen, Li; Zeng, Jing; Zhao, Shuai; Tang, Yong; Huang, Bixuan; Guan, Hansu; Chen, Yan; Feng, Yuchao; Lei, Sisi; Wu, Qihua; Zhang, Haobo; Huang, Xiaoyan; Zeng, Linsheng; Liu, Yuxiang; Zeng, Zhongyi; Chen, Bojun

doi:10.3389/fphar.2022.918689

Cited by 3 publications

(2 citation statements)

References 45 publications

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“…The effectiveness of TCM in the treatment of cardiovascular disease has been widely demonstrated in clinical practice (12)(13)(14)(15)(16). Despite high-quality randomized controlled trials being used in the current research, enhancing the external validity of clinical research and minimizing the differences between the trial and the real world are still necessary for translating research findings into clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Integrated Chinese and Western medicine for stable angina pectoris of coronary heart disease: a real-world study including 690 patients

Wang

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveWe aimed to evaluate the effects of integrated Chinese and Western medical therapeutic modalities on clinical prognosis in a population with stable angina pectoris (SAP) of coronary heart disease (CHD).MethodsIn a prospective cohort study, 732 patients with SAP of CHD hospitalized in the Integrated Cardiology Unit of the China-Japan Friendship Hospital From October 2020 to October 2021 were included. The patients were divided into integrated treatment and conventional treatment groups according to whether they had been taking Chinese medicine for more than 6 months per year. The occurrence of composite cardiovascular events (CVEs), including cardiac death, non-fatal myocardial infarction, revascularization, stroke, all-cause death, and readmission due to angina attack, heart failure, or malignant arrhythmia, was recorded during follow-up. The effects of different treatment modalities on prognosis were evaluated using univariate and multifactorial logistic regression. Logistic regression models were evaluated using receiver operating characteristic (ROC) curves. In sensitivity analysis, the correlation between treatment modality and outcome events was corrected by rematching the two groups of patients using the propensity score matching (PSM) method.ResultsThe data from 690 patients were included in the analysis, with 327 patients in the integrated treatment group and 363 patients in the conventional treatment group. CVEs occurred in 19 patients (5.8%) in the integrated treatment group and 37 patients (10.2%) in the conventional treatment group. The proportion of outcome events was significantly lower in the combination treatment group than in the conventional treatment group (P = 0.037). Covariate correction by multimodal multifactorial logistic regression revealed a lower risk of CVEs in patients receiving integrated therapy compared with conventional therapy (OR = 0.246, 95% CI = 0.097–0.622, P = 0.003). Moreover, a history of renal insufficiency (OR = 3.991, 95% CI = 1.164–13.684, P = 0.028) and a higher Gensini score (OR = 1.039, 95% CI = 1.028–1.050, P < 0.001) were risk factors for the development of CVEs. Model evaluation showed that C-statistic = 0.955 and area under the ROC curve (AUC) = 0.955. After PSM correction, the results still showed that integrated Chinese and Western medical treatment reduced the occurrence of CVEs in patients compared with Western treatment alone (OR = 0.339, 95% CI = 0.131–0.874, P = 0.025).ConclusionIntegrated treatment based on Chinese and Western medicine might improve the prognosis and reduce the risk of CVEs in this disease population.Trial registrationChina Clinical Trials Registry, ChiCTR1800017891, Registered 20 August 2018, http://www.chictr.org.cn/showproj.aspx?proj = 30170.

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Section: Discussionmentioning

confidence: 99%

Integrated Chinese and Western medicine for stable angina pectoris of coronary heart disease: a real-world study including 690 patients

Wang

et al. 2023

Front. Cardiovasc. Med.

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“…The findings were reported by a systematic review and meta-analysis of 19 eligible trials concluding that the combination of SBP with conventional treatment trial groups could significantly reduce the incidence of MACE, enhance left ventricular ejection fraction (LVEF), and lessen N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels [29]. Similarly, the results from a systematic review and network meta-analysis of 179 eligible trials suggested that SBP combined with Western medicine is presumably the optimal treatment prescription for both clinically effective and cardiovascular event rates [30]. The present evidence confirmed the relative long-term safety of SBP, which does not affect liver and kidney function or increase the risk of bleeding [14,23,28,31,32].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness analysis of Shexiang Baoxin Pill (MUSKARDIA) as the add-on treatment to standard therapy for stable coronary artery disease in China

Pan,

Ping,

Wang

et al. 2024

PLoS ONE

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Background Recent evidence indicates that Shexiang Baoxin Pill (MUSKARDIA), as an add-on treatment to standard therapy for stable coronary artery disease (CAD), is effective. Nevertheless, the cost-effectiveness of introducing the Shexiang Baoxin Pill (Abbreviation SBP) to the current standard treatment for patients with CAD in China remains unknown. Objective The objective of this study was to assess the cost-effectiveness of introducing SBP into the current standard treatment in China for patients with CAD. Method The effects of two treatment strategies—the SBP group (SBP combined with standard therapy) and the standard therapy group (placebo combined with standard therapy)—were simulated using a long-term Markov model. The simulation subjects might experience non-fatal MI and/or stroke or vascular or non-vascular death events. The study parameters were primarily derived from the MUSKARDIA trial, which was a multicenter, double-blind, placebo-controlled phase IV randomized clinical trial. Furthermore, age-related change, event costs, and event utilities were drawn from publicly available sources. Both costs and health outcomes were discounted at 5.0% per annum. One-way and probabilistic sensitivity analyses were conducted to verify the robustness of the model. Based on the MUSKARDIA trial results, the risk with the events of major adverse cardiovascular events (MACE) was decreased (P < 0.05) in the female subgroup treated with SBP therapy compared with standard therapy. Consequently, a scenario analysis based on subgroups of Chinese females was conducted for this study. Incremental cost-effectiveness ratios (ICERs) were assessed for each strategy for costs per quality-adjusted life-year (QALY) saved. Results After 30 years of simulation, the SBP group has added 0.32 QALYs, and the cost has been saved 841.00 CNY. Compared with the standard therapy, the ICER for the SBP therapy was -2628.13 CNY per QALY. Scenario analyses of Chinese females showed that, after 30 years of simulation, the SBP therapy has been increased by 0.82 QALYs, and the cost has been reduced by 19474.00 CNY. Compared with the standard therapy, the ICER for the SBP therapy was -26569.51 CNY per QALY. Similar results were obtained in various extensive sensitivity analyses. Conclusions This is the first study to evaluate the cost-effectiveness of SBP in the treatment of CAD. In conclusion, SBP as an add-on treatment to standard therapy appears to be a cost-effective strategy for CAD in Chinese patients.

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Acupuncture for perimenopausal stable angina pectoris with insomnia: A protocol for randomized, double-blind, placebo-controlled trial research

Shi,

Liu,

Meng

et al. 2023

Preprint

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Background Insomnia has emerged as a major public health issue jeopardizing human wellbeing. Furthermore, insomnia and angina arise concomitantly and exert reciprocal effects. Multiple studies suggest that perimenopausal females are more prone to experiencing both angina and insomnia, consequently substantially compromising their quality of life.Credible evidence suggests that acupuncture exerts a beneficial impact in alleviating insomnia. Nevertheless, the exhaustive investigation into the potential of acupuncture for mitigating insomnia co-occurring with stable angina in perimenopausal females remains a realm yet to be traversed in the realm of randomized controlled trials. Hence, the primary intent of this research protocol was to evaluate the effectiveness and safety profile of acupuncture when administered to perimenopausal subjects grappling with concomitant conditions of stable angina and insomnia. Methods This study entails a single-center, randomized, double-blind, placebo-controlled clinical trial. A total of 110 patients exhibiting insomnia concomitant with stable angina in the perimenopausal period will be enlisted and randomized to either acupuncture or sham acupuncture. Participants in both arms will undergo 30-minute sessions thrice weekly over a 12-week intervention period, with a 12-week maximum follow-up. The primary outcome measure is the Pittsburgh Sleep Quality Index(PSQI). Secondary outcomes encompass the Health-Related Quality of Life Questionnaire (SF-36), Dosage of hypnotic medications, SAP-associated evaluations (including C-reactive protein, lipoprotein-associated phospholipase A2, cardiac fatty acid-binding protein levels, and the Seattle Angina Questionnaire), the Hamilton Depression Inventory (HAMD), and the Generalized Anxiety Disorder Scale (GAD-7). Primary and secondary outcomes will be evaluated at baseline, 4 weeks, 8 weeks, 12 weeks (upon completion of the intervention), and at an additional 12-week follow-up. Any adverse events will be rigorously classified and characterized with respect to time of onset and abatement, therapeutic interventions implemented, impact on the primary morbidity, and regression. Discussion The current study is poised to furnish pivotal clinical data on the utility of acupuncture for stable angina with concomitant insomnia in perimenopausal women, with the findings to be propagated through academic conferences and peer-reviewed publications. Trial registration: TCTR20221121001. Registered 19 November 2022

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The comparative effects of oral Chinese patent medicines combined with western medicine in stable angina: A systematic review and network meta-analysis of 179 trials

Cited by 3 publications

References 45 publications

Integrated Chinese and Western medicine for stable angina pectoris of coronary heart disease: a real-world study including 690 patients

Integrated Chinese and Western medicine for stable angina pectoris of coronary heart disease: a real-world study including 690 patients

Cost-effectiveness analysis of Shexiang Baoxin Pill (MUSKARDIA) as the add-on treatment to standard therapy for stable coronary artery disease in China

Acupuncture for perimenopausal stable angina pectoris with insomnia: A protocol for randomized, double-blind, placebo-controlled trial research

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