Article type
Abstract
Introduction
Tongxinluo capsule (TXL) is used widely in China for acute coronary syndromes (ACS) after percutaneous coronary intervention (PCI) (ACS-PCI). This systematic review assessed the therapeutic effects and safety of adding TXL to Western medical therapy (WM) in patients with ACS-PCI.
Methods
A structured systematic search was performed in the PubMed, Cochrane, CNKI, VIP and Wanfang databases on January 2024, for randomized controlled trials (RCTs) that evaluated the therapeutic effects and safety of TXL added into WM for ACS-PCI. Risk ratios (RR) and the number-needed-to-treat (NNT) were used for dichotomous outcomes, and mean difference (MD) for continuous outcomes. Certainty of evidence was assessed using the GRADE approach.
Results
Fifteen studies involving 1506 participants were identified. Low-certainty evidence showed statistically significant effectiveness in favour of adding TXL to WM in reducing restenosis (RR = 0.30, 95% CI [0.10, 0.91]; NNT = 18), revascularisation (RR = 0.29, 95% CI [0.09, 0.95]; NNT = 15), angina (RR = 0.35, 95% CI [0.18, 0.67]; NNT = 14) and other cardiovascular events (RR 0.40, 95% CI [0.22, 0.72]; NNT = 13), increasing SAQ scores (MD 7.97, 95% CI [6.24, 9.71]) and improving life quality (qualitative analysis). However, there were no statistically significant effectiveness in reducing MI (RR 0.49, 95% CI [0.21, 1.13]; NNT = 35), sudden angina death (RR 0.40, 95% CI [0.11, 1.42]; NNT = 45) and non-cardiovascular adverse events (RR 0.68, 95% CI [0.27, 1.71]; NNT = 24) when adding TXL into the treatment compared with WM alone.
Conclusions
Current evidence suggests that the addition of TXL to WM in ACS-PCI treatment has significant benefits including reduced cardiovascular events (e.g., restenosis, revascularisation and angina incidence) and improves life quality. TXL supplementation did not increase the risk of non-cardiovascular adverse events. Our research sheds new evidence for ACS-PCI treatment with TXL.
Tongxinluo capsule (TXL) is used widely in China for acute coronary syndromes (ACS) after percutaneous coronary intervention (PCI) (ACS-PCI). This systematic review assessed the therapeutic effects and safety of adding TXL to Western medical therapy (WM) in patients with ACS-PCI.
Methods
A structured systematic search was performed in the PubMed, Cochrane, CNKI, VIP and Wanfang databases on January 2024, for randomized controlled trials (RCTs) that evaluated the therapeutic effects and safety of TXL added into WM for ACS-PCI. Risk ratios (RR) and the number-needed-to-treat (NNT) were used for dichotomous outcomes, and mean difference (MD) for continuous outcomes. Certainty of evidence was assessed using the GRADE approach.
Results
Fifteen studies involving 1506 participants were identified. Low-certainty evidence showed statistically significant effectiveness in favour of adding TXL to WM in reducing restenosis (RR = 0.30, 95% CI [0.10, 0.91]; NNT = 18), revascularisation (RR = 0.29, 95% CI [0.09, 0.95]; NNT = 15), angina (RR = 0.35, 95% CI [0.18, 0.67]; NNT = 14) and other cardiovascular events (RR 0.40, 95% CI [0.22, 0.72]; NNT = 13), increasing SAQ scores (MD 7.97, 95% CI [6.24, 9.71]) and improving life quality (qualitative analysis). However, there were no statistically significant effectiveness in reducing MI (RR 0.49, 95% CI [0.21, 1.13]; NNT = 35), sudden angina death (RR 0.40, 95% CI [0.11, 1.42]; NNT = 45) and non-cardiovascular adverse events (RR 0.68, 95% CI [0.27, 1.71]; NNT = 24) when adding TXL into the treatment compared with WM alone.
Conclusions
Current evidence suggests that the addition of TXL to WM in ACS-PCI treatment has significant benefits including reduced cardiovascular events (e.g., restenosis, revascularisation and angina incidence) and improves life quality. TXL supplementation did not increase the risk of non-cardiovascular adverse events. Our research sheds new evidence for ACS-PCI treatment with TXL.