Key result
PMA plus AM outperforms monotherapy for CHD arrhythmia efficiency and safety.
Why the study?
The optimal anti-arrhythmic drug or combination for improving arrhythmia in CHD patients remains unknown despite widespread clinical use of multiple drugs.
Do various anti-arrhythmic treatment strategies, including combinations of traditional Chinese medicine and chemical drugs, improve efficacy and safety in patients with arrhythmia of coronary heart disease?
Meta-Analysis (n=13,951)
Do various anti-arrhythmic treatment strategies, including combinations of traditional Chinese medicine and chemical drugs, improve efficacy and safety in patients with arrhythmia of coronary heart disease?
Combination therapies, particularly traditional Chinese medicine combined with chemical drugs (such as PMA+AM), appear to offer higher efficacy and safety for treating arrhythmia in patients with coronary heart disease.
Supports PMA+AM combinations for arrhythmia in coronary heart disease; extends meta-analytic evidence for superior efficacy and safety versus chemical drugs alone.
Purpose: Arrhythmia which as a common complication of CHD, has a high incidence. At present, more and more anti-arrhythmic drugs are used in clinical practice. However, which drug has the best efficacy and high safety is still unknown. Therefore, we decided to use NMA to solve this problem. Method: We searched CNKI, Wanfang database, VIP database, Pubmed, Embase and Cochrane libraries, and collected all RCTs of arrhythmia of CHD, and used RevMan (5.3) and Stata (13.0) to carry out this NMA. The primary outcome indicator of this study is efficiency; the secondary outcome indicator is the incidence of adverse reactions. Result: A total of 134 RCTs, 13,951 patients, and 11 treatment strategies were included in this NMA. The results show that all treatment strategies can effectively improve the arrhythmia of patients. Among them, PMA+AM, AM+AT, AM+WG have higher effective rates, and PMA+AM, WG+ME, SC+ME have better safety. The effectiveness and safety of the treatment strategies which combined TCM and chemical drugs, are significantly better than that of using chemical drugs alone. Conclusion: The treatment strategy of combination of multiple drugs usually has higher efficiency and safety. PMA+AM seems to be the most recommended treatment strategy. In addition, the rational combination of TCM and chemical drugs may provide potential benefit. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42021229693.
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Wang et al. (2021) conducted a meta-analysis in Arrhythmia of coronary heart disease (n=13,951). 11 treatment strategies (including combination of TCM and chemical drugs, e.g., PMA+AM) vs. Chemical drugs alone was evaluated on Efficiency (effective rates). Combination therapies, particularly PMA+AM, demonstrated higher efficiency and safety for treating arrhythmia in coronary heart disease compared to chemical drugs alone.
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