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Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis

BACKGROUND: Long-term use of nitrates for treating stable angina pectoris (SAP) may lead to patients' tolerance to nitrates. As a traditional Chinese medicine, Compound danshen dropping pills (CDDP) is beneficial for patients with SAP. This study aimed to critically assess the efficacy and safe...

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Autores principales: Zhang, Mengying, Wang, Wenjia, Sun, He, Zhai, Jingbo, Hu, Yunhui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240178/
https://www.ncbi.nlm.nih.gov/pubmed/37283584
http://dx.doi.org/10.3389/fcvm.2023.1168730
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author Zhang, Mengying
Wang, Wenjia
Sun, He
Zhai, Jingbo
Hu, Yunhui
author_facet Zhang, Mengying
Wang, Wenjia
Sun, He
Zhai, Jingbo
Hu, Yunhui
author_sort Zhang, Mengying
collection PubMed
description BACKGROUND: Long-term use of nitrates for treating stable angina pectoris (SAP) may lead to patients' tolerance to nitrates. As a traditional Chinese medicine, Compound danshen dropping pills (CDDP) is beneficial for patients with SAP. This study aimed to critically assess the efficacy and safety of CDDP vs. nitrates for SAP. METHODS: PubMed, Embase, Web of Science, Cochrane library, CNKI, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched from inception to April 2023. Randomized controlled trials (RCTs) comparing CDDP with nitrates for SAP were included. The meta-analysis was conducted to estimate the pooled effect. RESULTS: Twenty-nine studies were included for the statistical analysis. The meta-analyses with the random-effect model indicated that CDDP could significantly increase the effective rate in symptom improvement compared with nitrates (Pooled 9 RCTs, OR = 1.95, 95% CI: 1.25–3.05, P = 0.003, duration of 4 weeks; Pooled 4 RCTs, OR = 3.45, 95% CI: 1.84–6.48, P = 0.0001, duration of 6 weeks; Pooled 13 RCTs, OR = 4.02, 95% CI: 2.14–7.57, P < 0.0001, duration of 8 weeks). The meta-analyses with the random-effect model indicated that CDDP could significantly increase the effective rate in electrocardiogram improvement compared with nitrates (Pooled 5 RCTs, OR = 1.60, 95% CI: 1.02–2.52, P = 0.04, duration of 4 weeks; Pooled 3 RCTs, OR = 2.47, 95% CI: 1.60–3.82, P < 0.0001, duration of 6 weeks; Pooled 11 RCTs, OR = 3.43, 95% CI: 2.68–4.38, P < 0.00001, duration of 8 weeks). The incidence of adverse drug reactions in the CDDP group was lower than that in the nitrates group (Pooled 23 RCTs, OR = 0.15, 95% CI: 0.1–0.21, P < 0.00001). The results of the meta-analyses with fixed-effect model were similar with above results. The levels of the evidence ranged from very low to low. CONCLUSION: The present study suggests that CDDP with the duration of at least 4 weeks can be considered as an alternative to nitrates for treating SAP. However, more high-quality RCTs are still needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022352888, identifier [CRD42022352888].
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spelling pubmed-102401782023-06-06 Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis Zhang, Mengying Wang, Wenjia Sun, He Zhai, Jingbo Hu, Yunhui Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Long-term use of nitrates for treating stable angina pectoris (SAP) may lead to patients' tolerance to nitrates. As a traditional Chinese medicine, Compound danshen dropping pills (CDDP) is beneficial for patients with SAP. This study aimed to critically assess the efficacy and safety of CDDP vs. nitrates for SAP. METHODS: PubMed, Embase, Web of Science, Cochrane library, CNKI, Wanfang Digital Periodicals, and Chinese Science and Technology Periodicals database were searched from inception to April 2023. Randomized controlled trials (RCTs) comparing CDDP with nitrates for SAP were included. The meta-analysis was conducted to estimate the pooled effect. RESULTS: Twenty-nine studies were included for the statistical analysis. The meta-analyses with the random-effect model indicated that CDDP could significantly increase the effective rate in symptom improvement compared with nitrates (Pooled 9 RCTs, OR = 1.95, 95% CI: 1.25–3.05, P = 0.003, duration of 4 weeks; Pooled 4 RCTs, OR = 3.45, 95% CI: 1.84–6.48, P = 0.0001, duration of 6 weeks; Pooled 13 RCTs, OR = 4.02, 95% CI: 2.14–7.57, P < 0.0001, duration of 8 weeks). The meta-analyses with the random-effect model indicated that CDDP could significantly increase the effective rate in electrocardiogram improvement compared with nitrates (Pooled 5 RCTs, OR = 1.60, 95% CI: 1.02–2.52, P = 0.04, duration of 4 weeks; Pooled 3 RCTs, OR = 2.47, 95% CI: 1.60–3.82, P < 0.0001, duration of 6 weeks; Pooled 11 RCTs, OR = 3.43, 95% CI: 2.68–4.38, P < 0.00001, duration of 8 weeks). The incidence of adverse drug reactions in the CDDP group was lower than that in the nitrates group (Pooled 23 RCTs, OR = 0.15, 95% CI: 0.1–0.21, P < 0.00001). The results of the meta-analyses with fixed-effect model were similar with above results. The levels of the evidence ranged from very low to low. CONCLUSION: The present study suggests that CDDP with the duration of at least 4 weeks can be considered as an alternative to nitrates for treating SAP. However, more high-quality RCTs are still needed to confirm these findings. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022352888, identifier [CRD42022352888]. Frontiers Media S.A. 2023-05-22 /pmc/articles/PMC10240178/ /pubmed/37283584 http://dx.doi.org/10.3389/fcvm.2023.1168730 Text en © 2023 Zhang, Wang, Sun, Zhai and Hu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhang, Mengying
Wang, Wenjia
Sun, He
Zhai, Jingbo
Hu, Yunhui
Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title_full Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title_fullStr Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title_full_unstemmed Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title_short Compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
title_sort compound danshen dripping pills vs. nitrates for stable angina pectoris: a systematic review and meta-analysis
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10240178/
https://www.ncbi.nlm.nih.gov/pubmed/37283584
http://dx.doi.org/10.3389/fcvm.2023.1168730
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