Tong-xin-luo capsule for coronary heart disease after percutaneous coronary intervention

Cochrane: What is the efficacy and safety of chinese herbal medicine Tong-xin-luo capsules in preventing cardiovascular events after percutaneous coronary intervention, a procedure involving placing a stent to open up the heart's blood vessels, in patients with coronary heart disease? Coronary heart disease is a major cause of mortality globally. Percutaneous coronary intervention is regarded as a standard treatment for coronary heart disease to improve symptoms of heart-related chest pain. However, a major drawback of percutaneous coronary intervention is the need for a repeat procedure due to symptoms related to recurring narrowing of the heart's blood vessels. Previous studies have indicated that Tong-xin-luo capsule, a Chinese herbal medicine product, might be effective in preventing recurrence of narrowing of a blood vessel after percutaneous coronary intervention.

Study characteristics: We included sixteen randomised controlled trials (1063 participants) comparing Tong-xin-luo capsules plus conventional treatment with placebo plus/or conventional treatment (literature search date: though June 2014). All studies were undertaken in China. The sample size was from 50 to 178 and the duration of follow-up ranged from three months to two years.
We found that Tong-xin-luo may possibly reduce the risk of narrowing of a blood vessel detected by angiography, cardiovascular events (including myocardial infarction, angina and heart failure) and use of repeat procedure. Adverse events were seldom reported.
Quality of evidence: Because of high risk of bias for fifteen studies, imprecision and possible publication bias, the quality of evidence was low or very low for all study outcomes.

 

Authors' conclusions: 

The addition of Tong-xin-luo to conventional Western medicine may possibly prevent restenosis and recurrence of cardiovascular events in patients with CHD after PCI. However, the data are limited by publication bias and high risk of bias for included studies. Further high-quality trials are required to evaluate the potential effects of this intervention.