Your new experience awaits. Try the new design now and help us make it even better

SYSTEMATIC REVIEW article

Front. Pharmacol.

Sec. Ethnopharmacology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1632809

This article is part of the Research TopicInnovative Approaches and Molecular Mechanisms in Cardiovascular PharmacologyView all 20 articles

Tongxinluo Capsule for Acute Myocardial Infarction: A Systematic Review and Meta-analysis

Provisionally accepted
Yang  WuYang Wu1,2Jingxue  GuoJingxue Guo1,2Jiasai  FanJiasai Fan1,2Xian  WangXian Wang1,2*
  • 1Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
  • 2Beijing University of Chinese Medicine, Beijing, China

The final, formatted version of the article will be published soon.

Objective: To evaluate the clinical and preclinical effects of Tongxinluo Capsule (TXL) on acute myocardial infarction (AMI) and to summarize reported mechanisms of action, thereby informing clinical decision-making and future research. Methods: A comprehensive computerized search of eight databases and four clinical trial registries was performed from their inception until 1 April 2025. Data extraction, quality assessment and analysis were conducted in strict accordance with predefined protocols. The methodological quality of included studies was evaluated using the RoB-2 and SYRCLE tools. Statistical analyses were carried out using RevMan 5.4 software, employing fixed-effect or random-effects models as appropriate. Results: This review included 54 clinical studies (4353 patients in trail group;4296 patients in control group) and 11 animal studies (95 animals in trail group;94 animals in control group). Meta-analysis of clinical studies indicated that, compared with control groups, TXL was associated with lower all-cause mortality, cardiovascular mortality, and incidence of myocardial reinfarction (P < 0.05). Compared with control groups, TXL was associated with lower incidence of repeated revascularization, heart failure, angina pectoris, and arrhythmias (P < 0.05). Furthermore, TXL demonstrated greater improvement in cardiac function indicators and vascular endothelial function (P < 0.001), alongside significant reductions in blood lipids levels (P < 0.05)and inflammation markers. TXL was associated with fewer adverse reactions (P = 0.01), primarily gastrointestinal in nature. In animal studies, TXL was correlated with lower myocardial infarction area and the no-reflow area (P < 0.001) , higher cardiac function indicators (P < 0.05) and better vascular endothelial function (P < 0.05) compared to control group. Reported biological mechanisms of TXL include inhibition of apoptosis, suppression of inflammation, protection of cardiomyocytes and endothelial cells, promotion of angiogenesis, and synergistic lipid-lowering and plaque-stabilization effects. Conclusion: This study is the first meta-analysis to integrate both clinical and animal research on This is a provisional file, not the final typeset article TXL for AMI. The finding suggests that TXL may be associated with alterations in left ventricular systolic function and clinical prognosis, potentially mediated through mechanisms such as inhibition of apoptosis, protecting endothelial function, reducing of inflammation, preservation of cardiomyocytes, and promotion of angiogenesis.

Keywords: Tongxinluo, acute myocardial infarction, Meta-analysis, clinical studies, preclinical studies

Received: 21 May 2025; Accepted: 30 Sep 2025.

Copyright: © 2025 Wu, Guo, Fan and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xian Wang, wxian202212@163.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.