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)	𝑃 value^#	𝜒^2 statistic	𝑃 value*	𝐼^2 (%)	RR (95% CI)	RRR; (95% CI)	𝑃 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.