Systematic review of compound danshen dropping pill: a chinese patent medicine for acute myocardial infarction

Abstract

Objective. This paper systematically evaluated the efficacy and safety of compound Danshen dropping pill (CDDP) in patients with acute myocardial infarction (AMI). Methods. Randomized controlled trials (RCTs), comparing CDDP with no intervention, placebo, or conventional western medicine, were retrieved. Data extraction and analyses were conducted in accordance with the Cochrane standards. We assessed risk of bias for each included study and evaluated the strength of evidence on prespecified outcomes. Results. Seven RCTs enrolling 1215 patients were included. CDDP was associated with statistically significant reductions in the risk of cardiac death and heart failure compared with no intervention based on conventional therapy for AMI. In addition, CDDP was associated with improvement of quality of life and impaired left ventricular ejection fraction. Nevertheless, the safety of CDDP was unproven for the limited data. The quality of evidence for each outcome in the main comparison (CDDP versus no intervention) was "low" or "moderate." Conclusion. CDDP showed some potential benefits for AMI patients, such as the reductions of cardiac death and heart failure. However, the overall quality of evidence was poor, and the safety of CDDP for AMI patients was not confirmed. More evidence from high quality RCTs is warranted to support the use of CDDP for AMI patients.

Figure 1

Flow chart of study search and identification.

Figure 2

Risk of bias summary—all-cause mortality.

Figure 3

Risk of bias summary—cardiac mortality.

Figure 4

Risk of bias summary—recurrent myocardial infarction.

Figure 5

Risk of bias summary—heart failure.

Figure 6

Risk of bias summary—recurrent angina.

Figure 7

Risk of bias summary—readmission.

Figure 8

Risk of bias summary—QOL.

Figure 9

Risk of bias summary—LVEF.

Figure 10

Risk of bias summary—adverse events.