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Frontiers in Pharmacology 2020Dazhu hongjingtian [DZHJT, var. (Praeger) S.H. Fu] preparation as an add-on therapy has been applied to the treatment of angina pectoris. We aimed to evaluate the...
Dazhu hongjingtian [DZHJT, var. (Praeger) S.H. Fu] preparation as an add-on therapy has been applied to the treatment of angina pectoris. We aimed to evaluate the efficacy and safety of DZHJT as adjuvant therapy for the treatment of unstable angina pectoris (UAP). An extensive literature search was conducted on PubMed, Emase, Cochrane Library, Wanfang, CNKI, and VIP databases from inception to January 2019. Randomized controlled trials (RCTs) comparing DZHJT in combination with Western medicine with Western medicine alone were included. Two authors independently performed the literature search, data extraction and risk of bias assessment of included studies, and conducted the statistical analysis. A total of 18 RCTs involving 1,679 patients were included in the meta-analysis. Adjuvant treatment with DZHJT significantly decreased ≥80% reduction in the frequency of angina attacks [risk ratio (RR) 1.57; 95% CI 1.36-1.81], weekly frequency of angina attacks [mean difference (MD) -1.03 times; 95% confidence interval (CI) -1.51 to -0.55], marked improved abnormal electrocardiogram (RR 1.46; 95% CI 1.23-1.74). In addition, DZHJT significantly reduced the whole-blood viscosity (MD -0.70 mPa.s; 95% CI -0.84 to -0.55), plasma viscosity (MD -0.28 mPa.s; 95% CI -0.38 to -0.19), serum level of fibrinogen (MD -0.67 g/L; 95% CI -0.79 to -0.54), thromboxanes B2 (MD -14.01 ng/L; 95% CI -20.86 to -7.15), and C-reactive protein (MD -1.48 mg/L; 95% CI -2.72 to -0.25). No significant differences in headache/dizziness (RR 0.72; 95% CI 0.31-1.67) were observed between two groups. Adjuvant treatment with DZHJT has an add-on effect in reducing angina pectoris attacks in patients with UAP. The beneficial effect may be correlated with regulating whole-blood viscosity, plasma viscosity, fibrinogen, thromboxanes B2, and CRP level. However, future well-designed prospective, randomized, double-blind placebo-controlled trials with large sample sizes are required to evaluate the evidence.
PubMed: 32210811
DOI: 10.3389/fphar.2020.00213 -
Journal of Traditional Chinese Medicine... Jun 2019To assess the clinical efficacy and safety of ginkgo injections (GIs) combined with conventional treatment (CT) against angina pectoris (AP) due to coronary heart... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To assess the clinical efficacy and safety of ginkgo injections (GIs) combined with conventional treatment (CT) against angina pectoris (AP) due to coronary heart disease (CHD).
METHODS
Randomized controlled trials (RCTs) that used GIs to treat AP were searched in SinoMed, PubMed, China National Knowledge Infrastructure Database, Chinese Scientific Journals Database, Wanfang Database, Embase and Cochrane Library until March 2017. The Cochrane"risk of bias"method was used to evaluate the methodological quality of RCTs. Data were analyzed using Stata v13.1 and WinBUGS v1.4.3.
RESULTS
A total of 73 RCTs involving 7621 patients were included. A Bayesian network Meta-analysis of RCTs was undertaken, and the advantages of four types of GI-supplemented CT in AP treatment were determined.
CONCLUSION
GI-assisted CT was more effective against AP than CT alone. However, based on the limitations of the study, additional high-quality RCTs are required to confirm our findings.
Topics: Angina Pectoris; Animals; Coronary Disease; Ginkgo biloba; Humans; Network Meta-Analysis; Plant Extracts; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 32186000
DOI: No ID Found -
Medicine Jan 2020Coronary heart disease angina pectoris is a common clinical symptom in patients with coronary heart disease, due to coronary atherosclerotic stenosis or sputum leading...
BACKGROUND
Coronary heart disease angina pectoris is a common clinical symptom in patients with coronary heart disease, due to coronary atherosclerotic stenosis or sputum leading to coronary insufficiency, myocardial transient ischemia, hypoxia caused by precordial pain as the main clinical manifestations Group syndrome. Coronary heart disease angina causes coronary blood flow insufficiency, cannot meet the normal activities of myocardial cells, leading to myocardial ischemia or necrosis. When the disease occurs, there is paroxysmal and crushing pain in the precordial area of the patient. Therefore, we recognize the importance of the disease and have paid enough attention. Clinical studies in recent years have found that the use of acupuncture in the treatment of angina pectoris has a good clinical application prospect. This study was conducted to study the effect of using acupuncture to treat angina pectoris.
METHODS AND ANALYSIS
We will search for PubMed, Cochrane Library, AMED, EMbase, WorldSciNet, Nature, Science online and China Journal Full-text Database, China Biomedical Literature CD-ROM Database (CBM), and related randomized controlled trials included in the China Resources Database. The time is limited from the construction of the library to November 2019. We will use the criteria provided by Cochrane 5.1.0 for quality assessment and risk assessment of the included studies, and use the Revman 5.3 and Stata13.0 software for meta-analysis of the effectiveness, recurrence rate, and symptom scores of angina pectoris.
ETHICS AND DISSEMINATION
This systematic review will evaluate the efficacy and safety of acupuncture for angina pectoris. Because all of the data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process Trial.
REGISTRATION NUMBER
PROSPERO CRD42019138003.
Topics: Acupuncture Therapy; Angina Pectoris; Electrocardiography; Humans; Randomized Controlled Trials as Topic; Research Design
PubMed: 31914030
DOI: 10.1097/MD.0000000000018548 -
Medicine Dec 2019A growing number of studies suggest that Gualou Xiebai Banxia (GLXBBX) decoction, a well-known Chinese herbal formula, has beneficial effects on eliminating angina...
A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris.
BACKGROUND
A growing number of studies suggest that Gualou Xiebai Banxia (GLXBBX) decoction, a well-known Chinese herbal formula, has beneficial effects on eliminating angina pectoris symptoms and improving condition of stable angina pectoris (SAP) patients. However, whether this treatment is effective and safe for SAP or not, evidence supporting the effectiveness and safety of this treatment is still incomplete. Besides, there is lack of systematic review to assess the detailed situation (including risk of bias and methodology) of current related clinical studies. This study aimed to evaluate the effectiveness and safety of GLXBBX in treating SAP.
METHODS
The major databases (MEDLINE, Embase, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP) Database, Chinese Biomedical Database (CBM), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Database) were searched from inception to March 2019. Randomized controlled trials (RCTs) of GLXBBX alone or combined with conventional drugs against conventional drugs for SAP were identified. Two assessors reviewed each trial independently. The methodological quality of the eligible studies was evaluated according to the Cochrane Collaboration's tool for assessing risk of bias. Both the data extraction and the literature quality screening evaluation were conducted independently by 2 researchers.
RESULT
Totally 17 clinical RCTs were included in this study, involving 1676 patients. Due to the high probability of bias of the included studies, it was inappropriate to undertake a meta-analysis. Thus, we only conducted a systematic review and mainly discussed the methodology and limitation of the included studies.
CONCLUSION
Although the current evidence prompted that GLXBBX might benefit SAP patients in improvement of angina pectoris, ECG, and blood lipid on a certain extent, this systematic review revealed no definite conclusion about the application of GLXBBX for SAP due to the poor methodological quality, high risk of bias, and inadequate reporting on clinical data. More rigorous, multicenter, sufficient-sample, and double-blind randomized clinical trials are warranted.
Topics: Angina, Stable; Drugs, Chinese Herbal; Electrocardiography; Humans; Lipids; Randomized Controlled Trials as Topic
PubMed: 31860998
DOI: 10.1097/MD.0000000000018375 -
Heart (British Cardiac Society) Feb 2020
Meta-Analysis
Topics: Angina Pectoris; Cardiac Rehabilitation; Coronary Artery Bypass; Heart Failure; Humans; Myocardial Infarction; Myocardial Revascularization; Patient Compliance; Percutaneous Coronary Intervention; Secondary Prevention
PubMed: 31427366
DOI: 10.1136/heartjnl-2019-315348 -
Neuromodulation : Journal of the... Jan 2020The recent availability of paraesthesia/sensation free spinal cord stimulation (SCS) modalities allow the design of clinical trials of SCS using placebo/sham controls...
OBJECTIVES
The recent availability of paraesthesia/sensation free spinal cord stimulation (SCS) modalities allow the design of clinical trials of SCS using placebo/sham controls and blinding of patients, clinicians, and researchers. The aims of this study were to: 1) systematically review the current evidence base of randomized controlled trials (RCTs) of SCS placebo/sham trials and 2) to undertake a methodological critique of their methods. Based on this critique, we developed a checklist for the design and reporting of future RCTs of SCS.
MATERIALS AND METHODS
Electronic data bases were searched from inception until January 2019 for RCTs of SCS using a placebo/sham control. RCTs with only an active comparator arm were excluded. The results are presented as a narrative synthesis.
RESULTS
Searches identified 12 eligible RCTs. SCS modalities included paraesthesia stimulation, subthreshold, burst, and high-frequency SCS and were mainly conducted in patients with failed back surgery syndrome, complex regional pain syndrome, and refractory angina. The quality and transparency of reporting of the methods of placebo stimulation, blinding of patients, clinicians, and researchers varied markedly across studies.
CONCLUSIONS
To date the methods of placebo/sham control and blinding in RCTs have been poorly reported, leading to concerns about the validity and replicability of the findings. Important aspects that need to be clearly reported in the design of placebo-/sham-controlled RCTs of SCS include the transparent reporting of stimulation programming parameters, patient position during perception threshold measurement, management of the patient handheld programmer, frequency of recharging, and assessment of the fidelity of blinding.
Topics: Angina Pectoris; Complex Regional Pain Syndromes; Databases, Factual; Failed Back Surgery Syndrome; Humans; Placebo Effect; Randomized Controlled Trials as Topic; Spinal Cord Stimulation
PubMed: 31305001
DOI: 10.1111/ner.13018 -
International Journal of Circumpolar... Dec 2019The objective of this systematic review was to survey the current scientific knowledge regarding the state of somatic health among situation of the Indigenous Sami...
The objective of this systematic review was to survey the current scientific knowledge regarding the state of somatic health among situation of the Indigenous Sami people in Norway, Finland, Sweden and the Kola Peninsula in Russia; and assess the quality of the identified studies. A systematic search in the databases Pubmed, EBSCOhost (AMED, Medline, Cinahl) and Svemed was conducted from January 2000, through December 2017. This systematic search identified 399 articles. After screening abstracts, 93 articles were reviewed in full text, 32 of which met the inclusion criteria. The scientific quality of the evidence was rated according to the Newcastle-Ottawa scale. Based on the studies with moderate to high scientific quality, there is evidence for stating that the majority of the Sami included in this review experience good health. Mortality and life expectancy are similar, with only minor differences, to those of a non-Sami population. The cancer risk rate among Sami was lower than that of the general population of Norway, Sweden and Finland. Self-reported myocardial infarction prevalence was similar between Sami and non-Sami, but Angina pectoris was more prevalent among Sami. In Sweden, cardiovascular disease rates were similar between Sami and non-Sami. Musculoskeletal pain symptoms are common among the Sami population, as are obesity and overweight. To conclude, there are knowledge gaps in regard to the somatic health situation of the Indigenous Sami in the circumpolar area, especially in Russia, Finland and Sweden; as current knowledge is mainly based on publications from the SAMINOR study in Norway. No study obtained the highest quality score, suggesting a need to implement longitudinal prospective studies.
Topics: Finland; Health Status; Humans; Life Expectancy; Mortality; Norway; Population Groups; Russia; Sweden
PubMed: 31262241
DOI: 10.1080/22423982.2019.1638195 -
Open Heart 2019A systematic review was undertaken to assess the effects of exercise-based cardiac rehabilitation (CR) for patients with stable angina.
OBJECTIVE
A systematic review was undertaken to assess the effects of exercise-based cardiac rehabilitation (CR) for patients with stable angina.
METHODS
Databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase and CINAHL) were searched up to October 2017, without language restriction. Randomised trials comparing CR programmes with no exercise control in adults with stable angina were included. Where possible, study outcomes were pooled using meta-analysis. Grading of Recommendations Assessment, Development and Evaluation was used to assess the quality of evidence. The protocol was published on the Cochrane Database of Systematic Reviews.
RESULTS
Seven studies (581 patients), with a median of 12-month follow-up, were included. The effect of exercise-based CR on all-cause mortality (risk ratio (RR) 1.01, 95 % CI: 0.18 to 5.67), acute myocardial infarction (RR 0.33, 95% CI: 0.07 to 1.63) and cardiovascular-related hospital admissions (RR 0.14, 95% CI: 0.02 to 1.1) relative to control were uncertain. We found low-quality evidence that exercise-based CR results in a moderate improvement in exercise capacity (standard mean difference 0.45, 95% CI: 0.20 to 0.70). There was limited and very low-quality evidence for the effect of exercise-based CR on health-related quality of life (HRQoL), adverse events and costs. No data were identified on cost-effectiveness or return to work.
CONCLUSIONS
Exercise-based CR may improve the short-term exercise capacity of patients with stable angina pectoris. Well-designed randomised controlled trials are needed to definitely determine the impact of CR on outcomes including mortality, morbidity, HRQoL, and costs in the population of patients with stable angina receiving contemporary medical therapy.
PubMed: 31245012
DOI: 10.1136/openhrt-2018-000989 -
Journal of Sports Science & Medicine Jun 2019Exercise program has been associated with improved cardiovascular outcomes in patients sustaining coronary artery disease. However, little is known about the role of... (Meta-Analysis)
Meta-Analysis
Effects of Exercise after Percutaneous Coronary Intervention on Cardiac Function and Cardiovascular Adverse Events in Patients with Coronary Heart Disease: Systematic Review and Meta-Analysis.
Exercise program has been associated with improved cardiovascular outcomes in patients sustaining coronary artery disease. However, little is known about the role of exercise after percutaneous coronary intervention (PCI). Published literature was searched from Embase, PubMed, Wanfang Data, Cochrane Database of Systematic Reviews, China National Knowledge Infrastructure (CNKI) and Central Database. Exercise versus no exercise following PCI in the patients with coronary heart disease (CHD) was investigated in randomized trials. Left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), 6-minute walking distance (6MWD), cardiac death, myocardial infarction, coronary angioplasty, coronary artery bypass surgery (CABG), and angina pectoris or restenosis per randomized patients were analyzed by meta-analytic procedure to compare the curative effect of exercise program with exclusive exercise program after PCI. Ten randomized controlled trials including 1274 subjects (636 in exercise group and 638 in control group) were analyzed. The meta-analysis demonstrated that LVEF was significantly improved in exercise group (MD = 2.82, 95% CI [1.50, 4.14], p < 0.05). In contrast, the incidence rate of cardiac death (RR = 0.24, 95% CI [007, 0.76], p = 0.02), myocardial infarction (RR = 0.23, 95% CI [0.09, 0.57], p = 0.002), coronary angioplasty (RR = 0.47, 95% CI [0.26, 0.84], p = 0.01), angina pectoris (RR = 0.39, 95% CI [0.24, 0.64], p = 0.0002) and restenosis (RR = 0.36, 95% CI [0.16, 0.83], p = 0.02) were significantly lower in exercise group. LVEDD (MD = -2.01, 95% CI [-4.72, 0.70]), 6MWD (MD = 50.85, 95% CI [-13.24, 114.94]), and CABG (RD = -0.01, 95% CI [-0.05, 0.03]) were not significantly different in the patients with or without exercise (p = 0.71). Trial sequential analysis reflected traditional meta-analysis might generate a false positive conclusion for MI and cardiac death. There was no firm evidence to support the beneficial effects of exercise after PCI for the CHD patients to improve heart function or to reduce the incidence of adverse cardiovascular events.
Topics: Angina Pectoris; Coronary Artery Bypass; Coronary Artery Disease; Coronary Restenosis; Exercise Test; Exercise Therapy; Humans; Myocardial Infarction; Myocardial Revascularization; Percutaneous Coronary Intervention; Randomized Controlled Trials as Topic; Ventricular Function, Left
PubMed: 31191090
DOI: No ID Found -
Medicine Apr 2019In recent years, with the enormous advances in the field of cardiac intervention technology, the survival rate of patients with acute myocardial infarction (AMI) has...
The clinical efficacy and safety of the Chinese herbal medicine Astragalus (Huangqi) preparation for the treatment of acute myocardial infarction: A systematic review of randomized controlled trials.
BACKGROUND
In recent years, with the enormous advances in the field of cardiac intervention technology, the survival rate of patients with acute myocardial infarction (AMI) has been improved significantly. However, the risk of arrhythmias and heart failure remains very high in AMI patients for long-term prognosis. Chinese herbal medicine (CHM) is more and more used in the treatment of AMI because of its good curative effect and less side effects. The target of this research is to analyze the efficacy and safety of Astragalus (Huangqi) preparation in the treatment of AMI by meta-analysis and also to provide a better evidence for clinical practice.
METHODS
Seven databases will be searched in this study: The Cochrane Library, PubMed, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (CSJD), the Chinese Biomedical Literature Database (CBM), and Wanfang DATA. The following search terms will be used: (Huangqi OR Huang Qi OR Astragalus OR radix astragali) AND (acute myocardial infaction OR myocardial infaction OR AMI) AND (randomized controlled trial OR RCT OR randomized). No language limitations and the searches will be conducted up to March, 2019.
INCLUSION CRITERIA
randomized controlled trial (RCT) of Astragalus (Huangqi) preparation in patients with AMI. Main outcome measures will be left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), recanalization rate, mortality rate, incidence of reperfusion arrhythmias, postinfarction angina pectoris, and re-infarction rate. Secondary outcome indicators were the incidence of adverse reactions and the effective rate of traditional Chinese medicine (TCM) treatment. Two independent reviewers will filter the literature and extract data which based to the Cochrane manual. The relevant data, including bias risk assessment, data synthesis, subgroup analysis, meta-analysis, and final meta-analysis, will be analyzed with RevMan 5.3 software. The funnel diagram will be used to evaluate the reported deviation, and the Egger test will be used to evaluate the symmetry of the funnel graph.
RESULTS
This systematic review study will provide a clear basis for evaluating the efficacy and safety of Astragalus (Huangqi) preparation with the treatment of AMI.
CONCLUSION
This study will provide an up-to-date evidence for evaluating the efficacy and safety of Astragalus (Huangqi) preparation.
PROSPERO REGISTRATION NUMBER
CRD42019124843.
Topics: Drugs, Chinese Herbal; Humans; Myocardial Infarction; Randomized Controlled Trials as Topic
PubMed: 31008964
DOI: 10.1097/MD.0000000000015256