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. 2022 Jul 25:9:934598.
doi: 10.3389/fcvm.2022.934598. eCollection 2022.

Efficacy and safety of Puerarin injection on acute heart failure: A systematic review and meta-analysis

Zunjiang Li  1   2 , Ye Fan  1   2   3 , Chunxia Huang  1   2 , Quanle Liu  1   2   3 , Manhua Huang  1   2 , Baijian Chen  1   2   3 , Zhe Peng  1   2 , Wei Zhu  1   2   3 , Banghan Ding  1   2   3
Affiliations

Efficacy and safety of Puerarin injection on acute heart failure: A systematic review and meta-analysis

Zunjiang Li et al. Front Cardiovasc Med. .

Abstract

Objective: This study aimed to assess the adjunctive efficacy and safety of Puerarin injection (PI) on acute heart failure (AHF) based on a systematic review and meta-analysis.

Methods: Nine databases were searched from March 1990 to March 2022 to identify randomized controlled trials (RCTs) related to the adjunctive treatment of PI for AHF. The Cochrane collaboration tool was used to assess the risk of bias in the included studies. Meta-analysis and subgroup and sensitivity analyses were conducted by RevMan 5.3 software. The evidence's certainty was evaluated by grading recommendations assessment, development, and evaluation (GRADE) methods.

Results: A total of 8 studies were included with a total of 614 patients with AHF. The meta-analysis demonstrated that adjunctive treatment with PI on AHF was superior to conventional medicine alone. It increased the total effective rate (RR = 1.38; 95% CI, 1.22-1.55; p < 0.001) and improved left ventricular ejection fraction [SMD = 0.85; 95% CI (0.62, 1.09); p < 0.001]. Regarding safety, a total of 11.9% (23/194) adverse reactions were observed in the PI group and 9.8% (19/194) adverse reactions in the control group, and there were no significant differences in the incident rate of adverse events between both groups [RR = 1.16; 95% CI (0.66-2.05); p = 0.061]. The outcomes' evidentiary quality was assessed as "moderate."

Conclusion: PI had an adjunctive effect on AHF combined with conventional medicine, and it seemed to be safe and more effective than the conventional medical treatment alone for improving the total clinical effective rate and left ventricular ejection fraction. But further well-designed RCTs are required to confirm the efficacy and safety of XBP in treating AHF due to the poor methodological quality of the included RCTs.

Systematic review registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=327636], identifier [CRD42022327636].

Keywords: Puerarin injection; acute heart failure; meta-analysis; systematic review; traditional Chinese medicine.

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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
A PRISMA flow diagram of the literature screening and selection process.
FIGURE 2
FIGURE 2
Forest plot of total effective rate (the total effective rate = effective rate + significant effective rate; invalid rate: patient’s heart function, physical signs, and clinical AHF symptoms have not been improved or even worsen; effective rate: patient’s heart function improved with 1 level, physical signs, and clinical AHF symptoms are relieved; significant effect rate: patient’s heart function improved with 2 level or more, the heart rate decreased to normal level, physical signs, and clinical AHF symptoms have disappeared).
FIGURE 3
FIGURE 3
Forest plot of LVEF.
FIGURE 4
FIGURE 4
Forest plot of other heart function indicators.
FIGURE 5
FIGURE 5
Forest plot of left ventricular diastolic function.
FIGURE 6
FIGURE 6
Forest plot of adverse effect.
FIGURE 7
FIGURE 7
Funnel plot of publication bias assess. (A) Publication bias assess on total effective rate; (B) publication bias assess on LVEF; (C) Publication bias assess on adverse effect.
See this image and copyright information in PMC

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