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. 2022 Oct 3:13:972738.
doi: 10.3389/fphar.2022.972738. eCollection 2022.

Efficacy and safety of eight types Salvia miltiorrhiza injections in the treatment of unstable angina pectoris: A network meta-analysis

Mingxuan Li  1   2 , Hongdian Li  2 , Hongxu Liu  1 , Xiaolei Lai  1 , Wenlong Xing  1
Affiliations

Efficacy and safety of eight types Salvia miltiorrhiza injections in the treatment of unstable angina pectoris: A network meta-analysis

Mingxuan Li et al. Front Pharmacol. .

Abstract

Background: Salvia miltiorrhiza Bunge. [Lamiaceae, danshen] injection classes (SMIC) is widely used in the treatment of unstable angina (UA). However, it is uncertain which SMIC is more effective in terms of UA efficacy. The purpose of this Network Meta-analysis (NMA) was to compare the treatment effects of various SMIC to determine the best SMIC for the treatment of UA. Methods: The China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Web of Science, and Cochrane Library databases were searched to screen randomized controlled trials (RCTs) of SMIC for UA. The search time frame was all from the establishment of the database to May 2022. RevMan 5.3 and Stata 14.0 software were used for NMA. Results: A total of 148 studies including 14,979 patients, including 7,584 cases in the experimental group and 7,395 cases in the control group were included, and eight SMIC were extracted, namely:Danshen injection, Fufang Danshen injection, Guanxinning injection, Danshenchuanxiongqin injection, Danhong injection, Danshentong IIA Huangsuanna injection, Shenxiong Putaotang injection, and Danshenduofensuanyan injection. The results of NMA showed that, in terms of total effective rate, Shenxiong Putaotang injection and Danshenchuanxiongqin injection have the advantage; In terms of ECG efficiency, Danshentong IIA Huangsuanna injection and Danshen injection have an advantage; Danshenchuanxiongqin injection and Danshenduofensuanyan injection were more effective than other SMIC in improving angina pectoris attacks; Shenxiong Putaotang injection has an advantage in improving hs-CRP; Shenxiong Putaotang injection and Danshentong IIA Huangsuanna injection have advantages in improving TC and TG, respectively. Conclusion: The eight SMIC included in the current study were effective in treating UA, Shenxiong Putaotang injection and Danshentong IIA Huangsuanna injection were both superior in improving all outcome indicators. However, there is still a need for larger samples and high-quality randomized controlled trials for more refined comparisons of various SMIC. Systematic Review Registration: [PROSPERO], identifier [CRD42022350872].

Keywords: Chinese medicine injection; Salvia miltiorrhiza injection classes; Traditional Chinese Medicine; network meta-analysis; unstable angina (UA).

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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
Flowchart of study selection.
FIGURE 2
FIGURE 2
Results of risk of bias evaluation of included studies.
FIGURE 3
FIGURE 3
Reticulation of UA treated with SCMI.
FIGURE 4
FIGURE 4
Network diagrams of comparisons on different outcomes of treatments in different groups of patients with UA. (A) total effective rate; (B) ECG efficacy; (C) Angina pectoris attacks (weeks); (D) Angina pectoris attacks (days); (E) hs-CRP; (F) TC; (G) TG.
FIGURE 5
FIGURE 5
Pooled estimates of the network meta-analysis. (A) Pooled risk d ratios (95% credible intervals) for the total effective rate. (B) Pooled risk ratios (95% credible intervals) for ECG efficacy. (C) Pooled risk ratios (95% credible intervals) Angina pectoris attacks (w and d).(D) Pooled risk ratios (95% credible intervals) for hs-CRP.(E) Pooled risk ratios (95% credible intervals) for TC and TG.
FIGURE 6
FIGURE 6
SUCRA of comparisons on different outcomes of treatments in different groups of patients with UA. (A) total effective rate; (B) ECG efficacy; (C) Angina pectoris attacks (weeks); (D) Angina pectoris attacks (days); (E) hs-CRP; (F) TC; (G) TG.
FIGURE 7
FIGURE 7
Cluster analysis of comparisons on different outcomes of treatments in different groups of patients with UA. (A) total effective rate and ECG efficacy; (B) total effective rate and Angina pectoris attacks (weeks); (C) total effective rate and Angina pectoris attacks (days); (D) total effective rate and hs-CRP; (E) TC and TG.
FIGURE 8
FIGURE 8
Comparison-correction funnel chart for ending indicator, (A) Inclusion of total effective rate; (B) ECG efficacy; (C) Angina pectoris attack (weeks); (D) Angina pectoris attack (days); (E) hs-CRP; (F) TC; (G) TG.
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