Meta-analysis of Compound Danshen Dropping Pills in treatment of coronary heart disease combination with chemical drug after percutaneous coronary intervention
Objective To systematically review the effect of Compound Danshen Dropping Pills(CDDP)combined with chemical drug on adverse cardiovascular events and cardiac function for patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods Randomized controlled trials(RCTs)on CDDP in the treatment for patients with coronary heart disease after PCI were searched until October 31, 2023, through eight electronic databases: The CNKI, Wanfang, VIP, SinoMed,Pubmed, Cochranelibrary, Embase, Web of Science. This study used the Cochrane Risk Test bias tool in the Cochrane Handbook to assess the quality of the methodology. Review Manager 5.4 was used to analyze the results. Results A total of 26 RCTs were ultimately selected, with a total sample size of 3384 cases, including 1 692 cases in the treatment group and 1 692 cases in the control group. The Meta-analysis revealed significant reductions in the treatment group compared to the control group for primary outcomes, including angina pectoris recurrence [RR = 0.27, 95%CI (0.16, 0.45), P < 0.000 01], recurrent nonfatal myocardial infarction [RR = 0.30, 95% CI (0.15,0.60), P = 0.000 7], arrhythmia [RR = 0.75, 95%CI (0.62,0.90), P = 0.002], heart failure [RR =0.36,95%CI (0.21,0.60), P < 0.000 1], revascularization [RR = 0.18,95%CI (0.05, 0.66), P = 0.01], and stent restenosis [RR = 0.23,95%CI (0.10, 0.57), P = 0.001]. Compared to the control group, the treatment group significantly increased LVEF [MD = 4.13,95%CI (3.62,4.64), P < 0.000 01], decreased LVEDD [MD = -3.71, 95%CI (-4.37, -3.05), P < 0.000 01], and reduced NT-proBNP levels [MD = -325.48, 95%CI (-629.97, -21.00), P = 0.04]. However, there was no significant improvement in BNP levels[MD = -185.90, 95%CI (-413.12, -41.31), P = 0.11]. Regarding secondary outcomes, the treatment group demonstrated significant improvements in CI, SV, and LVESD compared to the control group (P < 0.05). In terms of adverse reactions, there was no statistically significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion The application of CDDP combined with chemical drug for the treatment of patients after PCI could reduce the occurrence of major adverse cardiovascular events (MACE), improve cardiac function in a safe and reliable manner.