PMID- 34781230
OWN - NLM
STAT- MEDLINE
DCOM- 20211203
LR  - 20211214
IS  - 1618-095X (Electronic)
IS  - 0944-7113 (Linking)
VI  - 94
DP  - 2022 Jan
TI  - Investigating the efficiency and tolerability of traditional Chinese formulas 
      combined with antiarrhythmic agents for paroxysmal atrial fibrillation: A 
      systematic review and Bayesian network meta-analysis.
PG  - 153832
LID - S0944-7113(21)00373-1 [pii]
LID - 10.1016/j.phymed.2021.153832 [doi]
AB  - BACKGROUND: The combination of antiarrhythmic drugs with traditional Chinese 
      formulas are used treatments for the management of paroxysmal atrial fibrillation 
      (PAF). However, the most effective treatment for PAF has yet to be been 
      determined. A Bayesian network meta-analysis study was thus performed for 
      comparing the relative efficacy and tolerability of different treatment 
      alternatives. METHODS: A comprehensive literature review of randomized controlled 
      trials (RCTs) is performed from eight database. Maintenance rate of sinus rhythm 
      (MRSR), p-wave dispersion (Pd), left atrium diameter (LAD), left ventricular 
      ejection fraction (LVEF), and adverse events (AEs) were used as outcomes. We also 
      estimated treatment rank based on the surface under the cumulative ranking curve 
      (SUCRA). This study was performed using a Bayesian network meta-analysis with a 
      random-effects model. FINDINGS: After screening, 59 RCTs involving 5,543 patients 
      and 16 treatments were included. The results showed that Shensong-Yangxin capsule 
      (SSYX) plus amiodarone (81%) was the most effective treatment for MRSR according 
      to the value of SUCRA, followed by Wenxin-Keli granules (WXKL) plus amiodarone 
      (73%). Meanwhile, SSYX plus amiodarone (7%) was most likely to reduce Pd, 
      followed by SSYX plus metoprolol (23%), WXKL plus amiodarone (26%), WXKL plus 
      bisoprolol (27%). Furthermore, SSYX plus amiodarone (4%) was more effective in 
      improving LAD. WXKL plus amiodarone was preferred because it had the lowest 
      toxicity. For benefit-risk ratio, amiodarone combined with WXKL or SSYX appeared 
      to be the best option. CONCLUSION: Antiarrhythmic agents combined with 
      traditional Chinese formulas had higher efficacy and lower toxicity than other 
      treatment alternatives. This study might provide reference to help find the 
      better treatment options for PAF.
CI  - Copyright (c) 2021. Published by Elsevier GmbH.
FAU - Jiang, Xiumin
AU  - Jiang X
AD  - Research Institute of Acupuncture and Moxibustion，Shandong University of 
      Traditional Chinese Medicine, Jinan, China; South China Research Center for 
      Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion 
      and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Luo, Yongxin
AU  - Luo Y
AD  - Department of Biostatistics and Preventive Medicine, School of Basic Medical 
      Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Wang, Xiaotong
AU  - Wang X
AD  - South China Research Center for Acupuncture and Moxibustion, Clinical Medical 
      College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of 
      Chinese Medicine, Guangzhou, China.
FAU - Chen, Yiming
AU  - Chen Y
AD  - South China Research Center for Acupuncture and Moxibustion, Clinical Medical 
      College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of 
      Chinese Medicine, Guangzhou, China.
FAU - Wang, Taiyi
AU  - Wang T
AD  - Research Institute of Acupuncture and Moxibustion，Shandong University of 
      Traditional Chinese Medicine, Jinan, China.
FAU - He, Jun
AU  - He J
AD  - South China Research Center for Acupuncture and Moxibustion, Clinical Medical 
      College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of 
      Chinese Medicine, Guangzhou, China; Rehabilitation Center, Counseling Department, 
      The First Affiliated Hospital of Guangzhou University of Chinese Medicine, 
      Guangzhou, China.
FAU - Xia, Yucen
AU  - Xia Y
AD  - Research Institute of Acupuncture and Moxibustion，Shandong University of 
      Traditional Chinese Medicine, Jinan, China.
FAU - Zhao, Jiaying
AU  - Zhao J
AD  - South China Research Center for Acupuncture and Moxibustion, Clinical Medical 
      College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of 
      Chinese Medicine, Guangzhou, China.
FAU - Chai, Xiaoshu
AU  - Chai X
AD  - Department of Oncology, Guangdong Provincial Hospital of Traditional Chinese 
      Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Yao, Lin
AU  - Yao L
AD  - Research Institute of Acupuncture and Moxibustion，Shandong University of 
      Traditional Chinese Medicine, Jinan, China; School of Pharmaceutical Sciences, 
      Guangzhou University of Chinese Medicine, Guangzhou, China.
FAU - Liu, Cunzhi
AU  - Liu C
AD  - International Acupuncture and Moxibustion Innovation Institute, School of 
      Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, 
      Chaoyang District, Beijing, China. Electronic address: lcz623780@126.com.
FAU - Chen, Yongjun
AU  - Chen Y
AD  - Research Institute of Acupuncture and Moxibustion，Shandong University of 
      Traditional Chinese Medicine, Jinan, China; South China Research Center for 
      Acupuncture and Moxibustion, Clinical Medical College of Acupuncture, Moxibustion 
      and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China. 
      Electronic address: ychen@gzucm.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20211029
PL  - Germany
TA  - Phytomedicine
JT  - Phytomedicine : international journal of phytotherapy and phytopharmacology
JID - 9438794
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - *Anti-Arrhythmia Agents/therapeutic use
MH  - *Atrial Fibrillation/drug therapy
MH  - China
MH  - Humans
MH  - Network Meta-Analysis
OTO - NOTNLM
OT  - Antiarrhythmic agents
OT  - Network meta-analysis
OT  - Paroxysmal atrial fibrillation
OT  - Systematic review
OT  - Traditional Chinese formulas
EDAT- 2021/11/16 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/11/15 20:27
PHST- 2021/08/01 00:00 [received]
PHST- 2021/09/30 00:00 [revised]
PHST- 2021/10/25 00:00 [accepted]
PHST- 2021/11/16 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/11/15 20:27 [entrez]
AID - S0944-7113(21)00373-1 [pii]
AID - 10.1016/j.phymed.2021.153832 [doi]
PST - ppublish
SO  - Phytomedicine. 2022 Jan;94:153832. doi: 10.1016/j.phymed.2021.153832. Epub 2021 
      Oct 29.