The safety and effectiveness of salvianolate in preventing perioperative venous thromboembolism in China

Abstract

Background: Salvianolate, a common drug for stabilizing heart disease and Angina Pectoris, is considered to be off-label for preventing venous thromboembolism (VTE) or anticoagulation at present. However, many clinical studies have showed that salvianolate can effectively inhibit the deep-vein thrombosis (DVT) incidence, and prevent VTE of perioperative patients in the real world in China. Objective: This analysis aimed to evaluate the effectiveness and safety of salvianolate in preventing VTE in perioperative patients. Methods: Databases of PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP were searched until July 2019. Literature retrieval, data extraction and quality assessment were independently completed by two researchers and checked with each other. Review Manager 5.2 software was applied for meta-analysis. Results: A total of 429 studies were retrieved, including 11 randomized controlled trials (RCTs) with a total of 1149 subjects. Compared with low molecular weight heparin (LMWH) group alone, salvianolate combined LMWH group had lower DVT incidence in preventing perioperative thrombosis (2.75% and 14.23%, OR: 0.21, 95% CI:[0.08,0.53]; P = .0009). The incidence of adverse reactions of experimental group was similar to that of control group (1.79% and 2.31%, OR: 0.65, 95% CI:[0.18,2.35]. P = .51). Compared with the control group, D-dimer level (D-D), platelet count (PLT), fibrinogen (FIB), whole blood high shear viscosity (WBHSV), and whole blood low shear viscosity (WBLSV) were all significantly decreased ( P < .01), and prothrombin time (PT) was significantly increased ( P < .05). Conclusion: Salvianolate combined LMWH has better effectiveness and the same safety in preventing venous thromboembolism in perioperative patients. However, due to the small number of included literatures, large sample studies are still needed to further verify this conclusion.

Efficacy and safety of salvianolate and enoxaparin in the prevention of perioperative deep venous thrombosis in gastrointestinal surgery

“…10,12 It is safe to prevent DVT during perioperative period without bleeding tendency and widely used in perioperative period in China. 15,17 Salvianolate is mainly composed of salvianolic acid B, which can inhibit the oxidation modification of low density lipoprotein, regulate blood lipids, reduce blood viscosity, enhance fibrinolytic activity, inhibit erythrocyte aggregation to improve high coagulation state and prevent thrombosis. [10][11][12]15,17 In this study, the incidence of DVT in salvianolate group was significantly lower than that in enoxaparin group.…”

“…15,17 Salvianolate is mainly composed of salvianolic acid B, which can inhibit the oxidation modification of low density lipoprotein, regulate blood lipids, reduce blood viscosity, enhance fibrinolytic activity, inhibit erythrocyte aggregation to improve high coagulation state and prevent thrombosis. [10][11][12]15,17 In this study, the incidence of DVT in salvianolate group was significantly lower than that in enoxaparin group. Although the changing trends of indexes in the two groups were roughly the same, the indexes…”

“…Studies have confirmed that compared with low‐molecular‐weight heparin calcium, salvianolate has more advantages in improving limb swelling, heavy feeling, and limb circumference after surgery 14–16 . A meta‐analysis of RCT studies found that salvianolate combined with LMWH had significant advantage in the VTE prevention in perioperative period than LMWH alone 17 . The purpose of this study was to investigate the safety and efficacy of salvianolate and enoxaparin in the prevention of DVT in gastrointestinal surgery during perioperative period.…”

“…[14][15][16] A meta-analysis of RCT studies found that salvianolate combined with LMWH had significant advantage in the VTE prevention in perioperative period than LMWH alone. 17 The purpose of this study was to investigate the safety and efficacy of salvianolate and enoxaparin in the prevention of DVT in gastrointestinal surgery during perioperative period.…”

Salvianolate Ameliorates Osteopenia and Improves Bone Quality in Prednisone-Treated Rheumatoid Arthritis Rats by Regulating RANKL/RANK/OPG Signaling

“…Accordingly, salvianolate injection has been used for coronary heart disease treatment in the clinic for more than 15 years in China. It has been used in clinical practice for the treatment and prevention of cardio-cerebral vascular diseases, and its safety profile is well established in China (Chen et al, 2016;Zhang et al, 2016;Dong et al, 2018;NanZhu et al, 2018;Shen et al, 2020;Chai et al, 2021). Our previous study showed that salvianolate attenuated osteogenic inhibition and suppressed hyperactive bone resorption, which lead to the recovery of bone mass and bone mechanical properties in prednisone-treated lupus mice (Liu et al, 2016).…”