Abstract
Objectives: To evaluate possible adverse effects and efficacy of Wenxin keli (WXKL)-amiodarone combination on heart failure complicated by ventricular arrhythmia.Methods: Nine electronic literature databases (the Cochrane Library, PubMed, EMBASE, IPA, AMED, CBM, CNKI, VIP, and WanFang) were searched up to February 2018. Two authors extracted data and assessed risk of bias of the included studies independently. Randomized controlled trials (RCTs) and quasi-RCTs about WXKL-amiodarone combination and amiodarone alone were eligible for comparison.Results: Thirteen trials involving 1,126 patients were included. Risk of bias was assessed as high in three studies and unclear in the remaining 10 studies. Six trials reported adverse events (AE). There was no obvious difference between WXKL-amiodarone combination group and amiodarone group in reported AEs (OR 0.64; 95%CI 0.39–1.07). The total effective rate of WXKL-amiodarone combination group was greater than that of amiodarone group (RR 1.22; 95%CI 1.16–1.29). The pooled results showed that the combination group was more effective in reducing heart rate (MD −2.25; 95%CI −2.61 to −1.88, P = 0.46, I2 = 0%), the frequency of ventricular premature complexes (MD −2.03; 95%CI −2.41 to −1.65) and QT dispersion (MD 5.59; 95%CI 3.60–7.58).Conclusion: The WXKL-amiodarone combination is safe and shows more protective effects on heart failure combined with ventricular arrhythmia compared with amiodarone alone. Further research is warranted, ideally involving large, prospective, rigorous trials, in order to confirm these findings.
Highlights
Heart failure (HF) is a major public health problem, with more than 23 million people worldwide (Roger, 2013)
The following search terms were used: (“WENXIN KELI” odds ratio (OR) “WENXINKELI” OR “wenxin-keli”) and (“amiodarone”) and (“heart failure complicated by ventricular arrhythmia” OR “cardiac failure complicated by ventricular arrhythmia” OR “heart decompensation complicated by ventricular arrhythmia”)
The results showed the combination significantly reduced the frequency of ventricular premature complexes (VPCs) compared with amiodarone therapy (MD = −2.03, 95%confidence interval (CI) −2.41 to −1.65)
Summary
Heart failure (HF) is a major public health problem, with more than 23 million people worldwide (Roger, 2013). The prevalence of HF is approximately ≥10% among the aged in developed countries (Ponikowski et al, 2016). Within the America alone, the total medical costs for patients with HF are expected to rise from $20.9 billion in 2012 to $53.1 billion by 2030 (Ziaeian and Fonarow, 2016). Ventricular arrhythmias (VA) include ventricular premature complexes (VPCs), ventricular tachycardia (VT) and ventricular fibrillation. HF and arrhythmia often appear simultaneously and promote each other to deteriorate (Saxon et al, 2006; Goldberger et al, 2011). The higher frequency of VA was associated with heart function decline (Santangeli and Marchlinski, 2015). The mutual mechanism includes inflammation, oxidative and microRNA regulation (Marfella et al, 2013)
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