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Review
. 2021 Apr 29:12:643446.
doi: 10.3389/fphar.2021.643446. eCollection 2021.

Comparison of the Efficacy of Danhong Injections at Different Time-points During the Perioperative Period of Acute Myocardial Infarction: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Qing-Ying He  1 , Xin-Yu Yu  2 , Zheng Xiao  3 , Xin Sun  4 , Wei-Feng Zhu  1 , Xing-Qian Yi  1 , Qian Chen  1 , Jia-Hui Zhang  1 , Shu-Xian Chen  1 , Xu Zhou  1 , He-Yun Nie  1 , Hong-Cai Shang  5 , Xiao-Fan Chen  1
Affiliations
Review

Comparison of the Efficacy of Danhong Injections at Different Time-points During the Perioperative Period of Acute Myocardial Infarction: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Qing-Ying He et al. Front Pharmacol. .

Abstract

Objectives: Danhong injections (DHI) are widely used in the treatment of acute myocardial infarction (AMI). As there are no guidelines for the timing of DHI in the peri-percutaneous coronary intervention (PCI) period for AMI, we investigated the effects of DHI timing. Methods: We reviewed reports published before September 30, 2020 in PubMed, embase, the Cochrane Central Register of Controlled Trials, the Chinese BioMedical database, Chinese VIP database, Wanfang database, and Chinese National Knowledge Infrastructure database. Only randomized controlled trials of DHI with percutaneous coronary intervention for AMI were included. Methodological quality was assessed using the Cochrane evaluation manual 5.3.3 criteria. A meta-analysis was performed, and forest plots were drawn. Results: We included 23 studies which all revealed that patients in DHI groups had better efficacy than control groups. Subgroup analysis revealed that DHI administered intraoperatively and continued postoperatively was more effective in increasing left ventricular ejection fraction when compared to other time-points (p < 0.001). The pre- and intraoperative use of DHI could improve reflow more effectively than conventional treatment, while the effect was not significant in the postoperative intervention study (p = 0.654). The 16 postoperative interventions revealed that the effect of DHI at 14 days was better than that at 7 and 10 days for hs-CRP (p = 0.013), the 10-days treatment produced better results for CK-MB than for the other treatments (p < 0.001) and a dosage of 30 ml proved most effective for IL-6 (p < 0.001). Conclusion: DHI proved to be superior to conventional Western medicine in reducing the incidence of adverse cardiac events, promoting reperfusion, improving cardiac function, reducing inflammatory factors, and protecting the myocardium. DHI should be administered early in the perioperative period and continued postoperatively because of its ability to improve cardiac function. Furthermore, in the PCI postoperative, 30 ml is recommended to inhibit IL-6 levels, for patients with high hs-CRP, a course of 14 days is most effective, for patients with obvious abnormalities of CK-MB, a 10-days course of treatment is recommended. However, due to the limited number and quality of the original randomized controlled trials, our conclusions need large, multi-centre RCTs to validation.

Keywords: acute myocardial infarction; danhong injection; intervention time point; meta-analysis; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Danhong injection for perioperative period of acute myocardial infarction.
FIGURE 2
FIGURE 2
Process of study extracted for the meta-analysis.
FIGURE 3
FIGURE 3
(A) Risk of bias summary. (B) Risk of bias graph.
FIGURE 4
FIGURE 4
The results of MACEs.
FIGURE 5
FIGURE 5
(A) The results of reflow. (B) The results of STR.
FIGURE 6
FIGURE 6
The results of LVEF.
FIGURE 7
FIGURE 7
(A) The results of cTnT. (B) The results of CK-MB.
FIGURE 8
FIGURE 8
(A) The results of Hs-CRP. (B) The results of IL-6.
FIGURE 9
FIGURE 9
The results of meta-regression.
FIGURE 10
FIGURE 10
The publication bias analysis.
See this image and copyright information in PMC

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References

    1. Allman K. C., Shaw L. J., Hachamovitch R., Udelson J. E. (2002). Myocardial Viability Testing and Impact of Revascularization on Prognosis in Patients with Coronary Artery Disease and Left Ventricular Dysfunction: a Meta-Analysis. J. Am. Coll. Cardiol. 39, 1151–1158. 10.1016/s0735-1097(02)01726-6 - DOI - PubMed
    1. Antman E. M., Anbe D. T., Armstrong P. W., Bates E. R., Green L. A., Hand M, et al. (2004). ACC/AHA Guidelines for the Management of Patients with ST-Elevation Myocardial Infarction; A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of Patients with Acute Myocardial Infarction). J. Am. Coll. Cardiol. 44, E1–e211. 10.1016/j.jacc.2004.07.014 - DOI - PubMed
    1. Brener S. J., Dambrink J. H., Maehara A., Chowdhary S., Gershlick A. H., Genereux P, et al. (2014). Benefits of Optimising Coronary Flow before Stenting in Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction: Insights from INFUSE-AMI. EuroIntervention 9, 1195–1201. 10.4244/eijv9i10a201 - DOI - PubMed
    1. Brener S. J., Ellis S. G., Schneider J., Topol E. J. (2002). Frequency and Long-Term Impact of Myonecrosis after Coronary Stenting. Eur. Heart J. 23, 869–876. 10.1053/euhj.2001.2976 - DOI - PubMed
    1. Brown K. N., Gupta N. (2020). Percutaneous Transluminal Coronary Arteriography. Treasure Island (FL) : StatPearls Publishing. - PubMed