Abstract
Background: Percutaneous coronary intervention (PCI) is widely used in treatment of acute coronary syndrome (ACS) clinically. It is believed that Danhong injection (DHI) extracted from salviae miltiorrhizae and flos carthami combined with PCI could increase the therapeutic efficacy on ACS. We provide an updated meta-analysis with detailed information on combination of DHI and PCI therapy.Materials and Methods: Electronic databases were searched for appropriate articles without language limitations on key words before October 22, 2017. All trails were screened according to certain criteria. Quality of eligible studies was also assessed. We made a detailed record of outcome measurements. RevMan 5.3 software was used to perform the meta-analysis.Results: 14 articles involving 1533 patients with ACS were selected. Compared to PCI treatment alone, total efficacy rate (TER) was enhanced and major adverse cardiovascular events (MACE) were reduced significantly for the combination of DHI and PCI (P < 0.00001). Vascular endothelial function was improved by significantly decreasing the contents of ET-1, vWF and increasing the levels of NO and FMD (P < 0.00001). The serum levels of IL-1, IL-6, IL-18, TNF-α, LpPLA2, MMP-9, and pentraxin-3 were significantly decreased (P < 0.00001), whereas IL-10 in serum was increased (P < 0.00001), indicating a stronger anti-inflammatory effect of the combination. The combination therapy decreased the serum levels of CD62P, PAGT, PADT, FIB-C significantly (P < 0.05), which was beneficial for preventing coagulation of platelets. Blood lipid was also affected by regulating TC, TG, LDL, and HDL, but the results were not statistically significant (P > 0.05). Cardiac function was improved by increasing LEVF (P = 0.006) but not LVED (P = 0.08). The combination treatment was associated with an improvement in antioxidant effect by decreasing MDA and increasing SOD significantly (P < 0.00001).Conclusion: Combination of DHI and PCI in treatment of ACS could improve TER and reduce incidence of MACE after PCI therapy. These effects may be mediated by combined actions of several mechanisms. However, these results of this study should be handled cautiously due to the limitations of this research. Several rigorous RCTs are in need to confirm these findings.
Highlights
Acute coronary syndrome (ACS) is the most severe form of Cardiovascular disease (CVD) and CVD accounts for approximately one-third of all global deaths (Chu et al, 2017)
Despite reestablishing the epicardial coronary vessel patently, Percutaneous coronary intervention (PCI) may associate with some pathological mechanisms including vascular endothelial dysfunction, aggregation of platelets, diffuse myocardial edema, and neutrophilic plugging which would lead to some major adverse cardiac events (MACE) and/or poor prognosis (Movahed and Butman, 2008; Kirtane et al, 2014; Bouleti et al, 2015)
The PCI therapy in eligible trails varied slightly and the usual regimen was the combination of clopidogrel, aspirin, low molecular heparin (LMH), β-receptor blocker or ACEI in PCI treatment
Summary
Acute coronary syndrome (ACS) is the most severe form of Cardiovascular disease (CVD) and CVD accounts for approximately one-third of all global deaths (Chu et al, 2017). Percutaneous coronary intervention (PCI) has become the most effective treatment for ACS (Sun et al, 2017). Danhong injection (DHI) is a Chinese patent medicine extracted from salviae miltiorrhizae and flos carthami. DHI is believed to have obvious therapeutic effects for patients with CVD including coronary heart disease (CHD), angina, myocardial infarction (MI), and cerebral infarction (CI) (Wang et al, 2014). We provide an updated and extended meta-analysis with detailed information for the combination of DHI and PCI on patients with ACS (Figure 1). It is believed that Danhong injection (DHI) extracted from salviae miltiorrhizae and flos carthami combined with PCI could increase the therapeutic efficacy on ACS. We provide an updated meta-analysis with detailed information on combination of DHI and PCI therapy
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