ABSTRACT
Objective: The primary objectives of this systematic review and meta-analysis were to assess the impact of Chinese herbal medicine (CHM) as an adjunctive therapy in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) and to evaluate its safety and efficacy. Methods: Studies were obtained from multiple databases, including PubMed, Web of Science, China National Knowledge Infrastructure Database (CNKI), WanFang Data (WanFang), and Chinese Science and Technology Journal Database (VIP). Randomized controlled trials evaluating the effects of CHM intravenously or orally in patients with CAD undergoing PCI were included. The primary outcome was improvements in major adverse cardiovascular events (MACEs), and the secondary outcomes included differences in echocardiography, serum biomarkers, vascular structures and functions, clinical symptoms, and adverse drug reactions. Data synthesis was conducted using relative risk (RR), weighted mean difference (MD), and 95% confidence intervals (CI). Results: Forty-seven trials, including 12,638 participants, were included in the meta-analyses. CHM significantly reduced MACEs compared with the control group(RR = 0.51, 95% CI= 0.45 to 0.58)). CHM also led to improvements in left ventricular ejection fraction((MD=6.93, 95% CI = 4.03 to 8.03), ventricular end-diastolic dimension(MD=-5.01, 95% CI = -7.0 to -3.03), and cardiac troponin-I levels(MD=-0.37, 95% CI = -0.77 to 0.03]). The anti-inflammatory effects of CHM were observed through downregulation of C-reactive protein(MD=-2.13, 95% CI = -3.1 to -1.05) and high-sensitivity CRP (MD=-1.47, 95% CI= -2.47 to -0.48) when compared with the control groups. CHM also showed a protective effect on renal function and augmented platelet inhibition(7.05, 95% CI=5.91 to 8.19, P < .00001). The blood stasis scores of patients treated with Chinese Medicine were lower in the CHM group (MD=-4.30, 95% CI= -6.53 to -2.07). No significant difference in adverse events was found between the CHM and control groups. Conclusion: The addition of CHM to conventional treatment in patients undergoing PCI for CAD improved primary and secondary endpoint events with no significant adverse drug reactions. These findings suggest that CHM has better clinical efficacy and safety. However, more high-quality studies are needed to validate these results and provide further evidence for the clinical application of CHM in CAD patients undergoing PCI.
