e0332 Tongxinluo capsule for coronary heart disease: a systematic review

Objective To assess the effectiveness and safety of tongxinluo capsule for coronary heart disease. Methods Trials were located electronic searches of the Cochrane Library (Issue 4, 2010), PubMed (1966 to April 2010), Wangfang (1984 to April 2010), CNKI (1979 to April 2010), VIP (1989 to April 2010), and CBM (1978 to April 2010). Randomised controlled trials (RCTs) and quasi-RCTs of tongxinluo capsule for coronary heart disease were included. Quality assessment and data extraction were conducted by two reviewers independently. Disagreement were resolved through discussion. All data were analysed using Review Manager 5.0. Results 13 studies involving a total of 1 496 participants met the inclusion criteria. Meta analysis results showed that: compared with nitrate esters, tongxinluo capsule for the coronary heart disease group had superiority in many aspects such as amelioration according to curative effect: tongxinluo capsule is better than isosorbide dinitrate [RR 0.50 and 95% CI 0.36 to 0.70], than isosorbide mononitrate [RR 0.19 and 95% CI 0.12 to 0.30], total efficacy [RR 0.34 and 95% CI 0.26 to 0.44, p<0.00001], the two groups had significant difference; Effectiveness according to EKG: tongxinluo capsule is better than isosorbide denigrate [RR 0.55 and 95% CI 0.46 to 0.66], than isosorbide mononitrate [RR 0.58 and 95% CI 0.48 to 0.70], total efficacy [RR 0.56 and 95% CI 0.49 to 0.64, p<0.00001], the two groups had significant difference; the tongxinluo group has a lower rates of adverse effect than itrate esters group. Meta-analysis results showed that the incidence rates of adverse effect [RR 0.33 and 95% CI 0.20 to 0.53], p<0.00001], the two groups had significant difference. Conclusion Now we have evidence to indicate that tongxinluo capsule can improve curative effect no worse than isosorbide dinitrate or isosorbide mononitrate, and have a lower rates of adverse effect. But more large scale multi center randomised trials are still needed.