SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Cardioprotective Effects of Puerarin Against Myocardial Ischemia-Reperfusion Injury: A Preclinical Systematic Review and Meta-Analyzes
Provisionally accepted
- Changchun University of Chinese Medicine, Changchun, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Myocardial ischemia-reperfusion injury (MIRI) remains a pivotal clinical conundrum in clinical cardiovascular practice, accounting for a substantial proportion of morbidity and mortality associated with cardiovascular disorders.Puerarin, a natural isoflavone from kudzu root, has shown promising cardioprotective potential in preclinical studies. Methods:Relevant studies were systematically searched PubMed, Embase, Cochrane Library, CNKI, Wanfang, VIP Database, and Web of Science from inception to October 2025 for preclinical studies evaluating puerarin’s effects on MIRI.Key outcome measures included myocardial infarct size,myocardial ischemic size,cardiac function parameters, myocardial injury markers, oxidative stress indicators, inflammatory cytokines, and cardiomyocyte apoptosis index. Methodological quality was assessed using the SYRCLE risk of bias tool and GRADE tool, meta-analyzes were performed with RevMan 5.4.1 and STATA 18.0. Results:A total of 29 eligible studies were included. This Meta-analyzes showed that puerarin administration reduced myocardial infarct size and myocardial ischemic size, improved cardiac systolic/diastolic function (e.g., increased LVEF, LVSP, LVFS; decreased LVIDd, LVEDP), attenuated myocardial injury (lower cTn-T, CK, CK-MB, LDH levels), suppressed oxidative stress (elevated SOD, NO; reduced MDA), inhibited inflammatory responses (decreased TNF-α, IL-1β, IL-6; increased GSH), and reduced cardiomyocyte apoptosis. Subgroup analysis indicated potential influences of administration route, dosage, and animal body weight on partial outcomes. Conclusion:Preclinical evidence demonstrates that puerarin exerts cardioprotective effects against MIRI through multi-target mechanisms, including mitigating oxidative stress, suppressing inflammation, and inhibiting cardiomyocyte apoptosis. Despite consistent preclinical efficacy, well-designed clinical trials are needed to validate its translational potential and safety in humans.
Keywords: animal model, meta-an alyzes, Myocardial ischemia-reperfusion, Puerarin, Systematic review
Received: 19 Dec 2025; Accepted: 09 Feb 2026.
Copyright: © 2026 Chen, Liang, Wang, Xue, shi, Yao, Wang and Jiang. 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: Lihong Jiang
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.