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Evidence-Based Complementary and Alternative Medicine
Volume 2013 (2013), Article ID 675906, 12 pages
http://dx.doi.org/10.1155/2013/675906
Review Article

Add-On Effect of Chinese Herbal Medicine on Mortality in Myocardial Infarction: Systematic Review and Meta-Analysis of Randomized Controlled Trials

1The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
2Chinese Medicine Department, Hong Kong Hospital Authority, Hong Kong

Received 31 August 2012; Accepted 16 November 2012

Academic Editor: Vassya Bankova

Copyright © 2013 Vincent C. H. Chung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In China, Chinese herbal medicine (CHM) is widely used as an adjunct to biomedicine (BM) in treating myocardial infarction (MI). This meta-analysis of RCTs evaluated the efficacy of combined CHM-BM in the treatment of MI, compared to BM alone. Sixty-five RCTs (12,022 patients) of moderate quality were identified. 6,036 patients were given CHM plus BM, and 5,986 patients used BM only. Combined results showed clear additional effect of CHM-BM treatment in reducing all-cause mortality (relative risk reduction (RRR) = 37%, 95% CI = 28%–45%, ) and mortality of cardiac origin (RRR = 39%, 95% CI = 22%–52%, ). Benefits remained after random-effect trim and fill adjustment for publication bias (adjusted RRR for all-cause mortality = 29%, 95% CI = 16%–40%; adjusted RRR for cardiac death = 32%, 95% CI = 15%–46%). CHM is also found to be efficacious in lowering the risk of fatal and nonfatal cardiogenic shock, cardiac arrhythmia, myocardial reinfarction, heart failure, angina, and occurrence of total heart events. In conclusion, addition of CHM is very likely to be able to improve survival of MI patients who are already receiving BM. Further confirmatory evaluation via large blinded randomized trials is warranted.