AUTHOR=Li Zunjiang , Fan Ye , Huang Chunxia , Liu Quanle , Huang Manhua , Chen Baijian , Peng Zhe , Zhu Wei , Ding Banghan 

TITLE=Efficacy and safety of Puerarin injection on acute heart failure: A systematic review and meta-analysis

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.934598

DOI=10.3389/fcvm.2022.934598

ISSN=2297-055X

ABSTRACT=Objective: This study aimed to assess the adjunctive efficacy and safety of Puerarin Injection (PI) on acute heart failure (AHF) by a systematic review and meta-Analysis.
Methods: Nine databases were searched from March 1990 to March 2022 to identify randomized controlled trials (RCTs) related to adjunctive treatment of PI for AHF. The Cochrane collaboration's tool was used to assess the risk of bias of included studies. Meta-analysis, subgroup and sensitivity analyses were conducted by RevMan 5.3 software. The evidence’s certainty was evaluated by grading recommendations assessment, development, and evaluation (GRADE) methods.
Results: A total of 8 studies were included with a total of 614 patients with AHF. The meta-analysis demonstrated that adjunctive treatment with PI on AHF was superior to conventional medicine alone. It improved the total clinical effective rate (RR = 1.38; 95% CI, 1.22 to 1.55; p < 0.001), and left ventricular ejection fraction (SMD = 0.85; 95% CI (0.62,1.09); p < 0.001). Regarding safety, a total of 5.92% (23/388) adverse reactions in the PI group and 4.90% (19/388) adverse reactions in the control group, no significant difference on the incident rate of adverse events were observed in both groups (RR = 1.16; 95% CI (0.66-2.05); p =0.061). The outcomes’ evidentiary quality was assessed as “moderate”.
Conclusion: PI have adjunctive effect on AHF combined with conventional medicine, it seemed to be safe and more effective than conventional medicine treatment alone on improving total clinical effective rate and left ventricular ejection fraction. But further well-designed RCTs are required to confirm the efficacy and safety of XBP in treating AHF due to the poor methodological quality of the included RCTs.