Key result
Guanxin Shutong capsule combined with standard treatment reduced the risk of angiographic restenosis by 76% (RR 0.24) compared to standard treatment alone in patients after percutaneous coronary intervention.
Why the study?
Although Chinese patent medicines have effectiveness in preventing coronary restenosis, the relative efficacy between different agents has not been sufficiently investigated.
Do Chinese patent medicines combined with standard treatment reduce restenosis and cardiovascular events in patients after percutaneous coronary intervention?
Meta-Analysis (n=5,077)
Do Chinese patent medicines combined with standard treatment reduce restenosis and cardiovascular events in patients after percutaneous coronary intervention?
Relative Risk: 0.24 (95% CI 0.11–0.45)
Chinese patent medicines combined with standard treatment may reduce the risk of coronary restenosis and related adverse events after PCI, though evidence certainty is low to moderate.
CPMs plus standard therapy may lower post-PCI restenosis risk; extends comparative RCT data but low-certainty evidence leaves practice implications open.
Background: Chinese patent medicines (CMPs) have curative effectiveness in preventing coronary restenosis. However, the relative efficacy between different CPMs has not been sufficiently investigated. Methods: Randomized clinical trials were searched from electronic databases including PubMed, Web of Science, Cochrane Library, Embase, CNKI, VIP, WanFang, SinoMed, Chinese Clinical Trial Registry, and ClinicalTrials.gov . Bayesian network meta-analysis was performed to analyze CPMs’ efficacy in preventing angiographic restenosis, recurrence angina, acute myocardial infarction, and target lesion revascularization after percutaneous coronary intervention. Results: This network meta-analysis included 47 trials with 5,077 patients evaluating 11 interventions. Regarding angiographic restenosis, the efficacy of CPMs (except Xuezhikang capsule) combined with standard treatment (Std) was superior to Std alone, and Guanxin Shutong capsule plus Std reduced the risk of angiographic restenosis by 76% (relative risk 0.24, 95% confidence interval 0.11–0.45, and very low to moderate certainty of evidence), most likely the best intervention. Fufang Danshen dripping pill combined with Std showed superiority over other interventions for relieving recurrence angina, which can reduce the risk by 83% (RR 0.17, 95% CI 0.04–0.51, very low to moderate certainty of evidence) compared to Std alone. In acute myocardial infarction after percutaneous coronary intervention, compared with Std alone, Danhong injection plus Std displayed a significant effect (RR 0.11, 95% CI 0.00–0.69, very low to moderate certainty of evidence) and was the best treatment probably. Chuanxiongqin tablet plus Std was the most effective treatment for reducing target lesion revascularization by 90% (RR 0.10, 95% CI 0.00–0.60, very low to moderate certainty of evidence) compared with Std alone. Conclusion: The results indicated that CPMs combined with Std reduced the risk of coronary restenosis after percutaneous coronary intervention. However, the results should be interpreted cautiously due to significant data limitations.
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Fan et al. (2024) conducted a meta-analysis in coronary restenosis after percutaneous coronary intervention (n=5,077). Guanxin Shutong capsule vs. Standard treatment alone was evaluated on Angiographic restenosis (target vessel lumen stenosis ≥50%) (RR 0.24, 95% CI 0.11-0.45). Guanxin Shutong capsule combined with standard treatment reduced the risk of angiographic restenosis by 76% (RR 0.24) compared to standard treatment alone in patients after percutaneous coronary intervention.
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