Add-On Effect of Chinese Herbal Medicine on Mortality in Myocardial Infarction: Systematic Review and Meta-Analysis of Randomized Controlled Trials
Table 2
Chinese herbal medicine plus biomedical treatment versus biomedical treatment alone for treating myocardial infarction: random-effect meta-analysis.
Events
No. of studies
No. of events/total no.
Combined effect
Test for heterogeneity
Adjusted combined effect (trim and fill)
CHM + BM group
BM group
RR (95% CI)
RRR (%) (95% CI)
value#
statistic
value*
(%)
RR (95% CI)
RRR (95% CI)
value#
Fatal events
All-cause mortality
44
308/5107
521/5112
0.63 (0.55–0.72)
37% (28%–45%)
<0.001
37.47
0.709
0.0
0.71 (0.60–0.84)
29% (16%–40%)
<0.001
Mortality of cardiac origin
10
142/2820
227/2796
0.61 (0.48–0.78)
39% (22%–52%)
<0.001
11.66
0.233
22.8
0.68 (0.54–0.85)
32% (15%–46%)
0.001
Fatal myocardial reinfarction
6
20/2660
37/2687
0.46 (0.19–1.12)
54% (12%–81%)
0.086
7.98
0.157
37.3
—
—
Fatal cardiac arrhythmia
3
4/162
5/160
0.71 (0.16–3.22)
29% (84%–222%)
0.662
2.21
0.331
9.6
—
—
Fatal heart failure
5
8/410
18/444
0.48 (0.21–1.09)
52% (9%–79%)
0.078
0.06
1.000
0.0
—
—
Fatal cardiogenic shock
4
37/330
58/332
0.72 (0.55–0.95)
28% (5%–45%)
0.019
2.42
0.490
0.0
—
—
Sudden cardiac death
9
61/2775
81/2795
0.76 (0.55–1.06)
24% (6%–45%)
0.104
3.13
0.926
0.0
—
—
Nonfatal events
Undifferentiated total heart events
11
209/2762
407/2761
0.52 (0.44–0.60)
48% (40%–56%)
<0.001
8.99
0.533
0.0
0.52 (0.44–0.62)
48% (38%–56%)
<0.001
Myocardial reinfarction
23
103/2377
215/2343
0.48 (0.39–0.61)
52% (39%–61%)
<0.001
9.95
0.987
0.0
0.53 (0.43–0.66)
47% (34%–57%)
<0.001
Cardiac arrhythmia
30
398/1730
640/1696
0.59 (0.48–0.73)
41% (27%–52%)
<0.001
121.94
0.000
76.2
0.72 (0.58–0.89)
28% (11%–42%)
0.003
Heart failure
28
249/1825
496/1835
0.52 (0.42–0.64)
48% (36%–58%)
<0.001
51.86
0.003
47.9
0.60 (0.50–0.72)
40% (28%–50%)
<0.001
Cardiac rupture
3
2/122
7/134
0.44 (0.11–1.67)
56% (67%–89%)
0.224
0.60
0.740
0.0
—
—
Cardiogenic shock
14
63/1015
110/1030
0.63 (0.47–0.85)
37% (15%–53%)
0.002
10.65
0.640
0.0
0.75 (0.57–0.98)
25% (2%–43%)
0.036
Angina
24
177/1047
297/1001
0.47 (0.39–0.56)
53% (44%–61%)
<0.001
22.20
0.508
0.0
0.58 (0.48–0.69)
42% (31%–52%)
<0.001
Adverse events
Undifferentiated total events
2
43/2434
39/2436
1.16 (0.59–2.27)
16% (41%–127%)
0.664
2.19
0.138
54.4
—
—
Bleeding
9
81/706
81/745
0.97 (0.73–1.28)
3% (27%-28%)
0.816
4.89
0.769
0.0
—
—
#Test for overall effect; *chi-square test for heterogeneity. BM: biomedical treatment; CHM: Chinese herbal medicine treatment; RR: relative risk; RRR: relative risk reduction; 95% CI: 95% confidence interval.
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