What does this research mean for the field?

Ginseng-containing traditional Chinese medicine combined with conventional western therapy improves clinical efficacy, cardiac function, and quality of life in patients with acute decompensated heart failure compared to western therapy alone. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

January 10, 2023Frontiers in PharmacologyOpen Access

The efficacy of ginseng-containing traditional Chinese medicine in patients with acute decompensated heart failure: A systematic review and meta-analysis

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Why the study?

The efficacy of ginseng-containing traditional Chinese medicine in patients with acute decompensated heart failure needed systematic evaluation.

Does ginseng-containing traditional Chinese medicine combined with conventional western therapy improve clinical outcomes in patients with acute decompensated heart failure?

Structured PICO

Does ginseng-containing traditional Chinese medicine combined with conventional western therapy improve clinical outcomes in patients with acute decompensated heart failure?

Population

Patients with acute decompensated heart failure (ADHF) from 28 included articles.

Intervention

Ginseng-containing traditional Chinese medicine (TCM) combined with conventional western therapy (WT)

Comparator

Conventional western therapy (WT) alone

Outcome

Clinical efficacy

Ginseng-containing TCM added to conventional western therapy may improve clinical efficacy and cardiac function in ADHF, though high-quality trials are needed to confirm these findings.

Limitations

limited by the quality of including trials
most studies included were with some concerns regarding risk of bias

Implication

May support adjunctive ginseng TCM in ADHF; leaves open confirmation by rigorous RCTs.

Abstract

Objective: To evaluate the efficacy of ginseng-containing traditional Chinese medicine (TCM) for acute decompensated heart failure (ADHF). Methods: Seven databases were included from establishment until 10 July 2022. Pooled data were analyzed with random-effects model. The risk of bias was measured by the risk of bias tool for randomized trials (RoB 2). Modified Jadad scale score was used to assess the quality of including studies. The meta-analysis was performed with RevMan 5.3. Trial sequential analysis was assessed to avoid type I errors. We have registered our protocol in PROSPERO (CRD42021267742). Results: Twenty-eight articles were included. The results demonstrated that compared with conventional western therapy (WT), ginseng-containing TCM combined with WT further improved clinical efficacy (RR: 1.25, 95% CI: 1.20–1.29, p < 0.00001, I 2 = 8%), left ventricular ejection fraction (LVEF) (MD: 5.80, 95% CI: 4.86–6.74, p < 0.00001, I 2 = 89%), stroke volume (MD: 13.80, 95% CI: 12.66–14.95, p < 0.00001, I 2 = 93%), 6-min walk test (MD: 53.03, 95% CI: 20.76–85.29, p = 0.001, I 2 = 97%), decreased 6-month rehospitalization (RR: 0.44, 95% CI: 0.18–1.11, p = 0.08, I 2 = 0%), brain natriuretic peptide (MD: 188.12, 95% CI: 248.13 to -128.11, p < 0.00001, I 2 = 94%), N-terminal pro-B-type natriuretic peptide (MD = -503.29; 95% CI: 753.18 to -253.40, p < 0.0001, I 2 = 89%) and Minnesota living heart failure questionnaire scores (MD: 9.68, 95% CI: 13.67 to -5.70, p < 0.00001, I 2 = 83%). The ROB2 assessment and modified Jaded scores showed most studies included were with some concerns. Conclusion: Compared with WT alone, ginseng-containing TCM is a possible way to benefit ADHF patients. However, limited by the quality of including trials, more high-quality studies are needed to provide reliable evidence.