The effectiveness and safety of oral Chinese patent medicines in treating myocardial infarction complicated with heart failure: a network meta-analysis of 12 interventions

Objective To systematically evaluate the effectiveness of different oral Chinese patent medicines (CPMs) combined with conventional treatment (CT) in the treatment of myocardial infarction with heart failure (MI-HF) using a Bayesian network Meta-analysis. Methods Computerized searches were conducted in CNKI, WanFang, VIP, SinoMed, PubMed, EMbase, Web of Science, and the Cochrane Library for relevant randomized controlled trials (RCTs) published from database inception until October 15, 2025. The quality of the included studies was assessed using the Cochrane Risk of Bias tool (RoB2). Statistical analysis was performed using Stata 17.0 and RevMan 5.3. Results A total of 42 RCTs were included, involving 12 oral CPMs, 6 outcome indicators and adverse reactions. In terms of improving the total clinical effective rate, Yixinshu capsules demonstrated the best therapeutic effect. Xintong oral liquid showed the best effect in improving LVEF and reducing LVESD. For reducing LVEDD, Shexiang Baoxin pill was optimal. Guanxin Shutong capsules were the most effective for lowering NT-proBNP and increasing the 6 MWT distance. Conclusion Oral CPMs combined with CT significantly improve cardiac function, ventricular remodeling, and exercise tolerance in MI-HF. While short-term tolerability is favorable, poor reporting limits definitive safety conclusions. Notably, Xintong Oral Liquid, Guanxin Shutong Capsules, and Qili Qiangxin Capsules exhibit the most outstanding comprehensive benefits. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ , PROSPERO CRD420251234570.