Chen Yifan, Wang Liuding, Cui Zhijie, Jiang Zhonghui, Gao Zhuye
Department of Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Department of Encephalopathy, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
J Ethnopharmacol. 2025 Feb 27;342:119419. doi: 10.1016/j.jep.2025.119419. Epub 2025 Jan 27.
Tongxinluo (TXL), a Chinese patent medicine, is commonly used for secondary prevention of cardiovascular events.
To evaluate the efficacy and safety of TXL for secondary prevention after ST-segment elevation myocardial infarction (STEMI).
A search for relevant randomized controlled trials (RCTs) was conducted across seven electronic databases from inception to May 10, 2024. Two independent reviewers conducted trial selection, data collection, and bias assessment. We performed a meta-analysis of efficacy and safety outcomes, and assessed the quality of evidence.
Ten RCTs were included, involving 4690 patients with STEMI. Compared to conventional treatments (CTs) alone, TXL combined with CTs reduced the incidence of major adverse cardiac and cerebrovascular events (MACCEs) in patients with STEMI (risk ratio [RR] = 0.61, 95 % confidence interval [CI] 0.51 to 0.73, P < 0.00001). TXL also contributed to improving cardiac function (mean difference [MD] = 4.95, 95 % CI 3.26 to 6.64, P < 0.00001). Furthermore, no statistically significant difference was observed in the incidence of adverse events between the TXL and control groups. The certainty of evidence was evaluated as moderate to low.
TXL might provide preventive effects against MACCEs for patients with STEMI. However, the efficacy and safety of TXL for secondary prevention in real-world settings require further confirmation through future practice.
通心络（TXL）是一种中成药，常用于心血管事件的二级预防。
评估通心络在ST段抬高型心肌梗死（STEMI）后二级预防中的疗效和安全性。
从数据库建立至2024年5月10日，在七个电子数据库中检索相关随机对照试验（RCT）。两名独立评审员进行试验筛选、数据收集和偏倚评估。我们对疗效和安全性结果进行了荟萃分析，并评估了证据质量。
纳入10项RCT，涉及4690例STEMI患者。与单纯常规治疗（CT）相比，通心络联合CT可降低STEMI患者主要不良心脑血管事件（MACCE）的发生率（风险比[RR]=0.61，95%置信区间[CI]0.51至0.73，P<0.00001）。通心络还有助于改善心功能（平均差[MD]=4.95，95%CI 3.26至6.64，P<0.00001）。此外，通心络组与对照组不良事件发生率无统计学显著差异。证据确定性评估为中到低。
通心络可能对STEMI患者的MACCE具有预防作用。然而，通心络在现实环境中二级预防的疗效和安全性需要通过未来实践进一步证实。
