Key result
Xiaoxinbi formula plus metoprolol lowers resting LVOTG by ~57% vs placebo in HCM.
Why the study?
Hypertrophic cardiomyopathy is the most common genetic heart disease, and this study aimed to evaluate the efficacy and safety of several medications to recommend better drug treatments for adults with HCM.
Do medications such as metoprolol, mavacamten, and N-acetylcysteine reduce resting left ventricular outflow tract gradient in adults with hypertrophic cardiomyopathy?
Meta-Analysis (n=377)
Do medications such as metoprolol, mavacamten, and N-acetylcysteine reduce resting left ventricular outflow tract gradient in adults with hypertrophic cardiomyopathy?
Effect estimate: MD -56.50% (95% CI -72.43%, -40.57%)
In adults with hypertrophic cardiomyopathy, metoprolol, mavacamten, N-acetylcysteine, and xiaoxinbi formula plus metoprolol significantly reduce resting left ventricular outflow tract gradients compared to placebo.
Supports Xiaoxinbi-metoprolol combination for LVOT gradient control in HCM; extends adjunctive options in meta-analysis.
Background: Hypertrophic cardiomyopathy (HCM) is the most common genetic heart disease. The purpose of this study was to evaluate the efficacy and safety of several medications and recommend better drug treatments for adults with HCM. Methods: A review of PubMed, Embase, the Cochrane Controlled Register of Trials (CENTRAL), ClinicalTrials.gov and CNKI databases was conducted for studies on the efficacy and safety of drugs for adults with HCM. A frequentist random effects model was used in this network analysis. Results: This network meta-analysis included 7 studies assessing seven medications, 6 studies evaluating monotherapy and 1 study evaluating combination therapy. Based on the network meta-analysis results, xiaoxinbi formula plus metoprolol (MD -56.50% [-72.43%, -40.57%]), metoprolol (MD -47.00% [-59.07%, -34.93%]) and mavacamten (MD -34.50% [-44.75%, -24.25%]) significantly reduced the resting left ventricular outflow tract gradient (LVOTG) in comparison with placebo. Resting LVOTG could also be reduced with N-acetylcysteine (NAC). The incidence of adverse drug reactions was not significantly different between the placebo group and the treatment group. Conclusion: : [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=374222], identifier [CRD42022374222].
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Mi et al. (2023) conducted a meta-analysis in Hypertrophic cardiomyopathy (n=377). Xiaoxinbi formula plus metoprolol vs. Placebo was evaluated on Change in resting left ventricular outflow tract gradient (LVOTG) from baseline (MD -56.50%, 95% CI -72.43%, -40.57%). Xiaoxinbi formula plus metoprolol significantly reduced the resting left ventricular outflow tract gradient compared to placebo (MD -56.50%) in adults with hypertrophic cardiomyopathy.
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