Efficacy and safety of traditional Chinese medicine injection in the treatment of ventricular remodeling after acute myocardial infarction: A network meta-analysis

BACKGROUND: This study attempted to assess the efficacy and safety of different herbal injections in combination with conventional therapy (CT) for the treatment of postinfarction ventricular remodeling using a net meta-analysis. METHODS: The search was conducted as of April 2024 in the China Knowledge Network Database, Chongqing Vip Database (VIP), Wanfang Platform Database (Wanfang), China Biomedical Literature Service System (SinoMed), PubMed, Web of Science Database, EMBASE, Cochrane Library for information about We searched the Cochrane Library for randomized controlled trials (RCTs) of herbal injections for postinfarction ventricular remodeling. Quality was assessed by the Cochrane Risk of Bias tool, and a net meta-analysis was performed to compare the efficacy and safety of different herbal injections in combination with conventional therapies. Data were analyzed and plotted using RevMan5.4, Stata18.0 MP software software. RESULTS: A total of 1948 records were retrieved, and 24 eligible RCTS were included, involving 2343 patients and 12 injections. The results of network meta-analysis showed that compared with conventional treatment, Shuxuetong injection + CT was significantly more likely to improve the clinical efficacy; Salvianolate injection + CT had the lowest incidence of adverse drug reaction. In terms of improving left ventricular ejection fraction, Guanxin Ning injection + CT was the best; In reducing left ventricular end-diastolic diameter, Xinmailong injection + CT has the best effect; In terms of reducing LVESD, Shenxiong injection + CT is the best. Chuanxiong Rhizoma injection + CT has the best effect on reducing left ventricular end-diastolic volume; In terms of reducing left ventricular end-systolic volume, Shenfu injection + CT has the best effect. The differences among the groups were statistically significant. Fourteen RCTS included reported the occurrence of adverse reactions, and the overall adverse reactions of TCM injection combined with conventional treatment were less than those of the control group. CONCLUSION: Current evidence suggests that the use of Chinese herbal injections in addition to conventional therapies may safely and effectively improve ventricular remodeling in patients with acute myocardial infarction and, to varying degrees, enhance cardiac function, quality of life, and prognosis.