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The effects of wenxin keli on left ventricular ejection fraction and brain natriuretic Peptide in patients with heart failure: a meta-analysis of randomized controlled trials.

Chen Y, Xiong X, Wang C, Wang C, Zhang Y, Zhang X, Gao Y, Xing Y, Li J, Wang J, Liu X, Xing Y - Evid Based Complement Alternat Med (2014)

Bottom Line: Objective.Methods.Eleven RCTs of WXKL were included.

View Article: PubMed Central - PubMed

Affiliation: Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, China ; Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, China.

ABSTRACT
Objective. To evaluate the beneficial and adverse effects of Wenxin Keli (WXKL), either alone or in combination with Western medicine, on the left ventricular ejection fraction (LVEF) and plasma brain natriuretic peptide (BNP) in the treatment of heart failure (HF). Methods. Seven major electronic databases were searched to retrieve potential randomized controlled trials (RCTs) designed to evaluate the clinical effectiveness of WXKL, either alone or in combination with Western medicine, for HF, with the LVEF or BNP after eight weeks of treatment as main outcome measures. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook for Systematic Review of Interventions, Version 5.1.0, and analyzed using RevMan 5.1.0 software. Results. Eleven RCTs of WXKL were included. The methodological quality of the trials was generally evaluated as low. The risk of bias was high. The results of the meta-analysis showed that WXKL, either alone or in combination with Western medicine, was more effective in LVEF and BNP, compared with no medicine or Western medicine alone, in patients with HF or HF complicated by other diseases. Five of the trials reported adverse events, while the others did not mention them, indicating that the safety of WXKL remains uncertain. Conclusions. WXKL, either alone or in combination with Western medicine, appears to be more effective in improving the LVEF and BNP in patients with HF and HF complications.

No MeSH data available.


Related in: MedlinePlus

Analysis of brain natriuretic peptide after eight months of treatment.
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Related In: Results  -  Collection


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fig3: Analysis of brain natriuretic peptide after eight months of treatment.

Mentions: Seven trials [12–18] used a reduction of BNP at eight months following treatment as an outcome measure. These trials compared the combination of WXKL with no medicine. The trial results for the seven independent trials were not homogeneous, X2 = 269.19, df = 6, (P < 0.00001); I2 = 98%, which required the use of the random effects model for the statistical analysis. The BNP level in the WXKL group (experimental group) was lower than that of the control group. The meta-analysis showed that there was a significant beneficial effect on the WXKL group compared with the control group, and there was a significant difference between the two groups for each of the three criteria outcome measures (SMD = −4.18, 95% CI = −5.89 to −2.47) (Figure 3). The main source of the significant heterogeneity of included trials may have several aspects. Firstly, the majority of the trials had poor methodological quality and a small sample size. Sample size calculation should be conducted before enrollment. If methodologically poorly designed, all the trials would show larger differences between experimental and control groups than those conducted rigorously. Secondly, there are differences in the severity of HF of patients in the included trials. Thirdly, in these trials, the method and instruments for testing the BNP level were various. This might lead to a significant heterogeneity of included trials. In addition, different diagnosis standards and different doctors' diagnosis can make a big difference. The diagnostic criteria of heart failure need to be unified and standardized in further research. So the clinical and methodological source made the heterogeneity of statistics.


The effects of wenxin keli on left ventricular ejection fraction and brain natriuretic Peptide in patients with heart failure: a meta-analysis of randomized controlled trials.

Chen Y, Xiong X, Wang C, Wang C, Zhang Y, Zhang X, Gao Y, Xing Y, Li J, Wang J, Liu X, Xing Y - Evid Based Complement Alternat Med (2014)

Analysis of brain natriuretic peptide after eight months of treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4020470&req=5

fig3: Analysis of brain natriuretic peptide after eight months of treatment.
Mentions: Seven trials [12–18] used a reduction of BNP at eight months following treatment as an outcome measure. These trials compared the combination of WXKL with no medicine. The trial results for the seven independent trials were not homogeneous, X2 = 269.19, df = 6, (P < 0.00001); I2 = 98%, which required the use of the random effects model for the statistical analysis. The BNP level in the WXKL group (experimental group) was lower than that of the control group. The meta-analysis showed that there was a significant beneficial effect on the WXKL group compared with the control group, and there was a significant difference between the two groups for each of the three criteria outcome measures (SMD = −4.18, 95% CI = −5.89 to −2.47) (Figure 3). The main source of the significant heterogeneity of included trials may have several aspects. Firstly, the majority of the trials had poor methodological quality and a small sample size. Sample size calculation should be conducted before enrollment. If methodologically poorly designed, all the trials would show larger differences between experimental and control groups than those conducted rigorously. Secondly, there are differences in the severity of HF of patients in the included trials. Thirdly, in these trials, the method and instruments for testing the BNP level were various. This might lead to a significant heterogeneity of included trials. In addition, different diagnosis standards and different doctors' diagnosis can make a big difference. The diagnostic criteria of heart failure need to be unified and standardized in further research. So the clinical and methodological source made the heterogeneity of statistics.

Bottom Line: Objective.Methods.Eleven RCTs of WXKL were included.

View Article: PubMed Central - PubMed

Affiliation: Shenyang Pharmaceutical University, Shenyang, Liaoning 110016, China ; Guang'anmen Hospital, Chinese Academy of Chinese Medical Sciences, Beijing 100053, China.

ABSTRACT
Objective. To evaluate the beneficial and adverse effects of Wenxin Keli (WXKL), either alone or in combination with Western medicine, on the left ventricular ejection fraction (LVEF) and plasma brain natriuretic peptide (BNP) in the treatment of heart failure (HF). Methods. Seven major electronic databases were searched to retrieve potential randomized controlled trials (RCTs) designed to evaluate the clinical effectiveness of WXKL, either alone or in combination with Western medicine, for HF, with the LVEF or BNP after eight weeks of treatment as main outcome measures. The methodological quality of the included studies was assessed using criteria from the Cochrane Handbook for Systematic Review of Interventions, Version 5.1.0, and analyzed using RevMan 5.1.0 software. Results. Eleven RCTs of WXKL were included. The methodological quality of the trials was generally evaluated as low. The risk of bias was high. The results of the meta-analysis showed that WXKL, either alone or in combination with Western medicine, was more effective in LVEF and BNP, compared with no medicine or Western medicine alone, in patients with HF or HF complicated by other diseases. Five of the trials reported adverse events, while the others did not mention them, indicating that the safety of WXKL remains uncertain. Conclusions. WXKL, either alone or in combination with Western medicine, appears to be more effective in improving the LVEF and BNP in patients with HF and HF complications.

No MeSH data available.


Related in: MedlinePlus