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Abstract
Objective Shexiang Baoxin Pill (SBP) is a licensed Chinese herbal pharmaceutical that has been widely accustomed to treat coronary heart disease (CHD) after percutaneous coronary intervention (PCI). This study points to systematically assess the efficacy and security of the combination of SBP with conventional western medicine in the treatment of CHD after PCI. Methods Databases including PubMed, the Cochrane Library, Web of Science, Embase, CNKI, Wanfang, VIP, and SINOMED were searched to collect RCTs on SBP in CHD after PCI before July 2021. Review Manager 5.3 was used to analyze the data. The Cochrane Collaboration Bias Risk Tool is used to assess the quality of methods. Results A total of 19 eligible trials of 2022 patients with CHD after PCI were finally included. The results of the aggregate evidence showed that, compared with routine western medicine treatment alone, the combination of SBP with conventional treatment trial groups could significantly reduce the incidence of major adverse cardiac events (MACE) of the patients (RR = 0.38, 95% CI (0.29, 0.51), P < 0.00001). SBP also significantly enhanced left ventricular ejection fraction (LVEF) (MD = 4.00, 95% CI (3.42, 4.58), P < 0.00001) and lessened N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels (MD = −167.18, 95% CI (−174.80, −159.57), P < 0.00001). In addition, the inflammatory mediators and blood lipid index in the experimental group after the combined therapy were also mediated (P < 0.05). Moreover, SBP did not increase the incidence of adverse reactions during treatment. The results of subgroup analysis illustrated that the length of the intervention course might be the source of the heterogeneity of NT-pro-BNP and hs-CRP. Conclusion SBP could demonstrate a beneficial role in patients with CHD after PCI of reducing the incidence of MACE and improving LVEF, NT-pro-BNP, inflammatory mediators, and blood lipid index. However, limited by the quantity and quality of eligible studies, the above conclusions required more standardized, rigorous, high-quality clinical trials to verify further.
Highlights
Cardiovascular disease (CVD) is one of the leading causes of morbidity and death worldwide, accounting for approximately 31.5% of global deaths and 45% of noncommunicable disease deaths
All studies had clear inclusion and exclusion criteria and reported that the baseline of the experimental and control groups was comparable. e intervention measures of the treatment group in all studies were conventional western medicine combined with the oral administration of Shexiang Baoxin Pill (SBP), and the intervention measures of the control group were conventional western medicine
An appropriate effect model was used for analysis, and the results showed that the experimental group could significantly reduce NT-pro-BNP (MD −67.76, 95% confidence interval (CI) (−94.18, −41.34), P < 0.00001). e results of the subgroup analysis suggested that the length of the intervention course may be the source of heterogeneity of NT-pro-BNP
Summary
Cardiovascular disease (CVD) is one of the leading causes of morbidity and death worldwide, accounting for approximately 31.5% of global deaths and 45% of noncommunicable disease deaths. Coronary heart disease (CHD) is the primary clinical manifestation of CVD [1, 2]. Percutaneous coronary intervention (PCI) can quickly recanalize the coronary arteries briefly, realize the prevention of vasodilation and secondary stenosis, and effectively improve the patient’s myocardial blood perfusion. It has become one of the main methods of clinical treatment for CHD [3]. In 2015, the number of interventional therapies for CHD in Mainland China reached 567,583, ranking second to the United States in the world. It should be noted that, according to the China Cardiovascular Intervention Forum (CCIF) report, this number reached 968,651 in 2020 [4].
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