July 29, 2022MedicineOpen Access

Cardioprotective effect of Chinese herbal medicine for anthracycline-induced cardiotoxicity in cancer patients: A meta-analysis of prospective studies

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Why the study?

The benefits and harmful effects of Chinese herbal medicine formulations in preventing anthracycline-induced cardiotoxicity needed to be assessed.

Does Chinese herbal medicine reduce the occurrence of clinical heart failure in cancer patients receiving anthracyclines?

Structured PICO

Does Chinese herbal medicine reduce the occurrence of clinical heart failure in cancer patients receiving anthracyclines?

Population

Cancer patients receiving anthracyclines (17 RCTs)

Intervention

Chinese herbal medicine (CHM) formulations (11 different CHMs)

Comparator

Control group

Outcome

Occurrence of clinical heart failurehard clinical

Chinese herbal medicine formulations may reduce the risk of clinical and subclinical heart failure in cancer patients receiving anthracyclines, though the quality of evidence is limited.

Limitations

insufficient quality of the included trials

Implication

May support CHM to mitigate ANT cardiotoxicity; leaves open need for confirmatory RCTs before practice change.

Abstract

BACKGROUND: To assess the benefits and harmful effects of Chinese herbal medicine (CHM) formulations in preventing anthracyclines (ANT)-induced cardiotoxicity. METHOD: The Cochrane Library, Pubmed and EMBASE databases were electronically searched for relevant randomized controlled trials (RCTs) published till December 2021 in English or Chinese-language, in addition to manual searches through the reference lists of the selected papers, and the Chinese Conference Papers Database. Data was extracted by 2 investigators independently. RESULT: Seventeen RCTs reporting 11 different CHMs were included in this meta-analysis. The use of CHM reduced the occurrence of clinical heart failure (RR 0.48, 95% CI 0.39 to 0.60, P < .01) compared to the control group. Data on subclinical heart failure in terms of LVEF values showed that CHM reduced the occurrence of subclinical heart failure (RR 0.47, 95% CI 0.35 to 0.62, P < .01) as well. CONCLUSION: CHM is an effective and safe cardioprotective intervention that can potentially prevent ANT-induced cardiotoxicity. However, due to the insufficient quality of the included trials, our results should be interpreted with cautious.