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Sodium Tanshinone II A Sulfonate for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials

  • Evidence-Based Integrative Medicine
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript

Abstract

Objective

To assess whether an adjunctive therapy of Sodium Tanshinone II A Sulfonate Injection (STS) is effective and safe in improving clinical outcomes in patients with coronary heart disease (CHD).

Methods

A literature search was conducted through PubMed, the Cochrane Library, Knowledge Infrastructure Databases (CNKI), Chinese Biomedical Literature Database (SinoMed), Chinese Science and Technology Periodical Database (VIP) and Wanfang Database up to August 2017. Randomized controlled trials (RCTs) comparing STS with placebo or no additional treatments on the basis of standard conventional medicine therapies were included. The outcomes were all-cause mortality, major acute cardiovascular events (MACEs), cardiac function and inflammatory factors. The risk of bias assessment according to the Cochrane Handbook was used to evaluate the methodological quality of the included trials. Revman 5.3 software was used for data analyses.

Results

A total of 22 RCTs involving 1,873 participants were included. All of the trials used STS as adjunctive treatment to standard conventional medicine therapy. Due to the poor quality of methodologies of most trials, only limited evidence showed that a combination of STS with percutaneous coronary intervention (PCI) or thrombolytic therapy (TT) might be more effective on reduction of all cause death rate than TT alone [risk ratio (RR) 0.25, 95% confidence interval (CI) 0.07 to 0.87] or PCI alone (RR 0.42, 95% CI 0.04 to 4.36). The results of 6 trials comparing STS plus TT with TT alone showed that the addition of STS significantly reduced the incidence of cardiac shock (RR 0.35, 95% CI 0.14 to 0.86), heart failure (RR 0.41, 95% CI 0.20 to 0.83) and arrhythmia (RR 0.21, 95% CI 0.12 to 0.46). STS combined with TT also showed a superior effect on cardiac function and inflammatory factor. No severe adverse event was reported related to STS.

Conclusions

As an adjunctive therapy, STS combined with standard conventional medicine seems to be more effective on all-cause mortality or MACEs than conventional medicine treatment alone with less side effects. However, we cannot make a firm conclusion due to low quality of inclusion trials. Well-designed trials with high methodological quality are needed to validate the effect of STS for CHD patients.

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Authors and Affiliations

  1. Graduate School, Beijing University of Chinese Medicine, Beijing, 100029, China

    Mei-li Yu & Jin-gen Li

  2. Cardiovascular Diseases Center, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 100091, China

    Si-ming Li, Hao Xu & Ke-ji Chen

  3. Tieying Hospital of Fengtai District, Beijing, 100079, China

    Xiang Gao

Authors
  1. Mei-li Yu
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  2. Si-ming Li
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  3. Xiang Gao
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  4. Jin-gen Li
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  5. Hao Xu
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  6. Ke-ji Chen
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Contributions

Yu ML was responsible for design of the protocol, data analysis, and draft manuscript. Li SM and Gao X participated in the literatures screening and quality assessment. Li JG participated in critical revision. Xu H and Chen KJ participated in conception and design of the study, critical revision and final approval of the manuscript.

Corresponding authors

Correspondence to Hao Xu or Ke-ji Chen.

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Conflict of Interests

There is no conflict of interests regarding the publication of this paper.

Supported by the Twelve Five-Year Plan of China (No. 2013BAI02B01) and the National Traditional Chinese Medicine Clinical Research Center Project (No. 2015ZSC02)

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Yu, Ml., Li, Sm., Gao, X. et al. Sodium Tanshinone II A Sulfonate for Coronary Heart Disease: A Systematic Review of Randomized Controlled Trials. Chin. J. Integr. Med. 26, 219–226 (2020). https://doi.org/10.1007/s11655-018-2556-7

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  • DOI: https://doi.org/10.1007/s11655-018-2556-7

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