Zhangsheng Wang1, Zeng Tang2, Wenqing Zhu3, Lei Ge4, Junbo Ge5. 1. Department of Cardiology, The Fifth People's Hospital of Shanghai, Fudan University, 801, Heqing Rd, Minhang District, Shanghai 200240, China. Electronic address: linerzhiqiu@126.com. 2. Shanghai Minhang Center for Disease Control and Prevention, Shanghai 201101, China. Electronic address: 13211020018@fudan.edu.cn. 3. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180, fenglin Road, Xuhui District, Shanghai 200032, China. Electronic address: zhu.wenqing@zs-hospital.sh.cn. 4. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180, fenglin Road, Xuhui District, Shanghai 200032, China. Electronic address: ge.lei@zs-hospital.sh.cn. 5. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180, fenglin Road, Xuhui District, Shanghai 200032, China. Electronic address: ge.junbo@zs-hospital.sh.cn.
Abstract
OBJECTIVES: Traditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF). METHODS: Potential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included. RESULTS: A total of 905 AF patients from 9 RCTs were identified. Meta-analysis showed that TCM in combination with warfarin was better than warfarin alone for preventing total thromboembolic events with a 68% reduction of risk (risk ratio [RR] 0.32; 95% confidence interval [CI] 0.13-0.78) without increasing the risk of total bleeding (RR 0.71; 95% CI 0.29-1.72). Compared with warfarin, TCM therapy was associated with lower risk of total bleeding (RR 0.13; 95% CI 0.04-0.47), but increased the risk of total thromboembolic events (RR 1.84; 95% CI 1.03-3.27). CONCLUSIONS: This meta-analysis suggests that TCM combined with warfarin is superior to warfarin alone for the prevention of total thromboembolic events in patients with AF, with equal risk of bleeding as warfarin alone.
OBJECTIVES: Traditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF). METHODS: Potential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included. RESULTS: A total of 905 AFpatients from 9 RCTs were identified. Meta-analysis showed that TCM in combination with warfarin was better than warfarin alone for preventing total thromboembolic events with a 68% reduction of risk (risk ratio [RR] 0.32; 95% confidence interval [CI] 0.13-0.78) without increasing the risk of total bleeding (RR 0.71; 95% CI 0.29-1.72). Compared with warfarin, TCM therapy was associated with lower risk of total bleeding (RR 0.13; 95% CI 0.04-0.47), but increased the risk of total thromboembolic events (RR 1.84; 95% CI 1.03-3.27). CONCLUSIONS: This meta-analysis suggests that TCM combined with warfarin is superior to warfarin alone for the prevention of total thromboembolic events in patients with AF, with equal risk of bleeding as warfarin alone.