Network Meta-analysis of Traditional Chinese Medicine Combined with PCI for Myocardial Infarction

OBJECTIVE To evaluate the clinical efficacy of different proprietary Chinese medicines in the treatment of myocardial infarction with PCI. Methods The PubMed, EMbase, The Cochrane Library, Web of Science, CBM, WanFang Data, VIP and CNKI databases were searched for randomized controlled trials (RCTs) of traditional Chinese medicine combined with PCI for myocardial infarction. Assessment of risk of inclusion in RCTs according to Cochrane Handbook. Statistical analysis was performed by R 3.4.3 software and Stata 14 software. Comparison of brain natriuretic peptide (BNP), major adverse cardiovascular events, and left ventricular ejection fraction in patients with myocardial infarction treated with PCI combined with Chinese medicines. RESULTS The 16 studies included 1 824 patients with myocardial infarction and 4 kinds of Chinese medicines (Shexiang Baoxin pills, Qishen Yiqi Dropping pills, Tongxinluo capsules, Compound Danshen Dropping pills). Network meta-analysis showed that using Chinese medicine combined with PCI was superior to PCI in improving left ventricular ejection fractions, and the difference was statistically significant(P<0.05). Shexiang Baoxin pills, Tongxinluo capsules and Compound Danshen Dropping pills could reduce the risk of cardiovascular events, and the difference was statistically significant (P<0.05). There was no statistically significant difference in the treatment of PCI between patients with traditional Chinese medicine and PCI in reducing BNP in myocardial infarction patients. CONCLUSION The available evidence shows that Chinese medicine combined with PCI treatment can benefit patients with myocardial infarction. However, due to the limitations of the quantity and quality of the included studies, the conclusions of this study need to be confirmed by more high-quality studies.