Abstract

Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33–0.78), myocardial infarction (RR = 0.32, 95% CI 0.14–0.72), heart failure (RR = 0.37, 95% CI 0.15–0.91), and angina (RR = 0.46, 95% CI 0.30–0.71) than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR = 0.46, 95% CI 0.32–0.66), myocardial infarction (RR = 0.37, 95% CI 0.26–0.54), and angina (RR = 0.36, 95%CI 0.26–0.51). Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR = 0.34, 95% CI 0.17–0.68) and angina (RR = 0.46, 95% CI 0.30–0.70) in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine.

Highlights

  • Angina is pain or constricting discomfort that typically occurs in the front of the chest and is brought on by physical exertion or emotional stress [1]

  • (1) The combination of Chinese herbal medicine (CHM) with western medicine may significantly reduce the occurrence of total heart events, MI, cardiac arrhythmia, heart failure, and angina compared with western medicine alone in patients with stable angina (SA). (2) For patients with unstable angina (UA), the combination therapy is superior to western medicine alone on total heart events, myocardial infarction, angina, and sudden cardiac death

  • There is no significant difference on the incidence of death, cardiac arrhythmia, hart failure, fatal events, cardiac surgery, and percutaneous coronary intervention

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Summary

Introduction

Angina is pain or constricting discomfort that typically occurs in the front of the chest and is brought on by physical exertion or emotional stress [1]. It is the main symptomatic manifestation of myocardial ischemia, caused by an imbalance between myocardial blood supply and oxygen demand [1, 2]. SA is a chronic medical condition and the aim of management for it is to abolish or minimize symptoms, improve quality of life, and decrease long-term morbidity and mortality [1] while UA is an acute coronary syndrome, which should be treated as an emergency [8]. Chinese herbal medicine (CHM) is widely used for treating angina in China [9]

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