A meta-analysis of wenxin granule and metoprolol for the treatment of coronary heart disease and arrhythmia

Background: This meta-analysis aimed to systematically and comprehensively assess the effectiveness and safety of wenxin granule (WXG) and metoprolol in the treatment of elderly patients with coronary heart disease (CHD) and arrhythmia. Methods: We searched the electronic databases of the Cochrane Library, PUBMED, EMBASE, CNKI, Wangfang, and CBM from initiation to May 1, 2022, and selected a set of clinical indicators for WXG and metoprolol for CHD and arrhythmia. The methodological quality of the included studies was analyzed using the Cochrane risk-of-bias tool. Data were pooled using a fixed-effects or random-effects model, and a meta-analysis was conducted. Results: Eight randomized controlled trials involving 722 patients with CHD and arrhythmia were included. Our findings showed that WXG and metoprolol showed better effects than metoprolol alone on electrocardiogram change (odds ratio [OR] = 7.21, 95% confidence interval [CI] [1.48, 35.07]), clinical symptom improvement (OR = 5.83, 95% CI [1.52, 22.35]), overall clinical effect (OR = 5.51, 95% CI [2.65, 11.44], P < .001), atrial premature beat (mean difference [MD] = −109.85, 95% CI [−171.25, −48.46], P < .001), ventricular premature beat (MD = −195.43, 95% CI [−334.09, −56.77], P < .001), borderline premature beat (MD = −42.92, 95% CI [−77.18, −8.67], P = .01), short-burst ventricular tachycardia (MD = −35.98, 95% CI [−39.66, −32.30], P < .001), ST segment reduction (MD = −0.47, 95% CI [−0.54, −0.40], P < .001), ST segment decrease duration (MD = −0.76, 95% CI [−0.95, −0.57], P < .001). However, no significant differences were observed in adverse reactions (OR = 0.54, 95% CI [0.27, 1.09], P = .09). Conclusion: Compared to metoprolol alone, WXG and metoprolol can more effectively manage patients with CHD and arrhythmia. However, additional large-scale, multicenter, rigorous, and high-quality randomized controlled trials are warranted to verify the present findings.