Key result
Chinese herbal medicine combined with biomedicine reduced all-cause mortality (RRR 37%; 95% CI 28-45%) and cardiac mortality compared to biomedicine alone in patients with myocardial infarction.
Why the study?
Does the addition of Chinese herbal medicine to biomedicine reduce mortality in patients with myocardial infarction?
Meta-Analysis (n=12,022)
Does the addition of Chinese herbal medicine to biomedicine reduce mortality in patients with myocardial infarction?
Effect estimate: RRR 37% (95% CI 28-45)
The addition of Chinese herbal medicine to standard biomedicine may significantly reduce all-cause and cardiac mortality in patients with myocardial infarction, though large blinded trials are needed to confirm these findings.
May reduce post-MI mortality when added to biomedicine; leaves open confirmation by large blinded RCTs.
In China, Chinese herbal medicine (CHM) is widely used as an adjunct to biomedicine (BM) in treating myocardial infarction (MI). This meta-analysis of RCTs evaluated the efficacy of combined CHM-BM in the treatment of MI, compared to BM alone. Sixty-five RCTs (12,022 patients) of moderate quality were identified. 6,036 patients were given CHM plus BM, and 5,986 patients used BM only. Combined results showed clear additional effect of CHM-BM treatment in reducing all-cause mortality (relative risk reduction (RRR) = 37%, 95% CI = 28%-45%, I(2) = 0.0%) and mortality of cardiac origin (RRR = 39%, 95% CI = 22%-52%, I(2) = 22.8). Benefits remained after random-effect trim and fill adjustment for publication bias (adjusted RRR for all-cause mortality = 29%, 95% CI = 16%-40%; adjusted RRR for cardiac death = 32%, 95% CI = 15%-46%). CHM is also found to be efficacious in lowering the risk of fatal and nonfatal cardiogenic shock, cardiac arrhythmia, myocardial reinfarction, heart failure, angina, and occurrence of total heart events. In conclusion, addition of CHM is very likely to be able to improve survival of MI patients who are already receiving BM. Further confirmatory evaluation via large blinded randomized trials is warranted.
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Chung et al. (2013) conducted a meta-analysis in Myocardial infarction (n=12,022). Chinese herbal medicine (CHM) plus biomedicine (BM) vs. Biomedicine (BM) alone was evaluated on All-cause mortality (RRR 37%, 95% CI 28-45). Chinese herbal medicine combined with biomedicine reduced all-cause mortality (RRR 37%; 95% CI 28-45%) and cardiac mortality compared to biomedicine alone in patients with myocardial infarction.
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