Yixinshu preparation for angina pectoris in coronary heart disease: A systematic review and meta-analysis

Angina pectoris presents a significant public health burden. With the aim of clarifying the clinical value of Yixinshu preparations, this study systematically reviewed the literature to assess their effectiveness as an adjunctive therapy for the management of angina pectoris in patients with coronary artery disease (CAD), and further explore the relationship between different administration methods of Yixinshu and clinical efficacy. A systematic search of PubMed, Embase, Cochrane Library, CNKI, CBM, VIP, and Wanfang Database was conducted to identify randomized controlled trials (RCTs) evaluating Yixinshu as an adjunct to conventional therapy for CAD and angina pectoris. The Cochrane risk of bias tool was used to assess methodological quality. Quantitative synthesis and subgroup analysis were performed using ReviewManager5.4 software, and sensitivity analysis was performed with Stata. Thirteen studies with 1502 patients were included. Compared with western medicine alone, adjunctive Yixinshu preparation significantly improved ECG outcomes [OR = 2.61,95%CI (1.81,3.74), P < 0.00001], and showed higher clinical efficacy in response rate [OR = 3.38,95%CI (2.38,4.80), P < 0.00001]. Significant reduction in the duration [MD = 1.25,95%CI (0.39,2.10) and frequency [MD = 1.04,95%CI (0.35, 1.73] of angina pectoris episodes were noted. Subgroup analysis revealed correlations between angina duration and dosage, as well as between angina frequency and both dosage and treatment regime. Regarding safety, adverse reactions were reported in five studies, with a relatively lower incidence in the experimental group. Adjunctive Yixinshu with routine pharmacological treatment significantly improves treatment efficacy in angina pectoris. The therapeutic effects on angina duration and frequency varied across different administration forms and dosages.