Zhongguo quanke yixue (Jan 2022)
Efficacy and Safety Combined with Conventional and Western Medicine Treatments on Coronary Heart Disease Complicated with Heart Failure：a Systematic Review
Abstract
BackgroundAnti-atherosclerotic and anti-heart failure therapies are the key to the treatment of coronary heart disease (CHD) , a common cardiovascular disease. At present, there are few comprehensive evaluation and analysis on the efficacy and safety of Sofren Injection (SI) in the treatment of coronary heart disease complicated with heart failure.ObjectiveTo systematically evaluate the efficacy and safety of SI combined with conventional and western treatment in the treatment of heart failure in complicated with CHD.MethodsPubMed, The Cochrane Library, EMBase, CNKI, CQVIP, SinoMed, Wanfang Data and other databases were searched from inception to June 7, 2020 . Randomized controlled trials (RCTs) of the application of SI in heart failure with CHD were screened and grouped, SI combined with conventional and western treatment as the experimental group, conventional and western treatment as the control group. Primary outcome indicators included left ventricular ejection fraction (LVEF) , left ventricular end-diastolic diameter (LVEDD) , left ventricular end-systolic diameter (LVESD) , left atrial end-diastolic diameter (LAEDD) , serum carbon monoxide (CO) , and NT-pro-brain natriuretic peptide (NT-proBNP) . Secondary outcome indicators included endothelin-1 (ET-1) , serum nitric oxide (NO) , overall clinical response rate, and incidence of adverse reactions. The Cochrane risk bias assessment tool was used to evaluate the quality of the included studies, and the RevMan 5.3 software was used for meta-analysis.ResultsEight documents meeting the criteria and 1 075 patients were included. Meta-analysis indicated that the experimental group was superior to the control group in improving heart function index: LVEF〔MD=-8.63, 95%CI (-12.33, -4.93) , P<0.05〕; LVEDD〔MD=5.71, 95%CI (4.82, 6.61) , P<0.05〕; LAEDD〔MD=6.62, 95%CI (5.36, 7.88) , P<0.05〕; LVESD〔MD=3.15, 95%CI (1.84, 4.46) , P<0.05〕; CO〔MD=-0.44, 95%CI (-0.62, -0.25) , P<0.05〕. The experimental group also had better effects on improving NT-proBNP 〔SMD=2.87, 95%CI (1.77, 3.97) , P<0.05〕. Moreover, the experimental group improved endothelial function index of ET-1〔MD=28.32, 95%CI (23.95, 32.68) , P<0.05〕, and NO〔MD=-16.74, 95%CI (-20.13, -13.35) , P<0.05〕 more significantly. The total clinical effective rate of the experimental group was better than that of the control group 〔RR=1.25, 95%CI (1.18, 1.32) , P<0.05〕.ConclusionThe clinical efficacy of the experimental group on coronary heart disease combined with heart failure is better than that of the control group, which can improve heart function, heart failure markers, endothelial function indicators with good safety. However, the number of existing clinical studies is small and the quality is low, and more high-quality clinical studies are still needed for verification.
Keywords
