Effect of Sodium Tanshinone IIA Sulfonate Injection on Blood Lipid in Patients With Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Hufang Zhou; Ying Zhao; Wenhua Peng; Wenbo Han; Zichen Wang; Xiaoxia Ren; Dayang Wang; Guozhong Pan; Qian Lin; Xian Wang

doi:10.3389/fcvm.2021.770746

Effect of Sodium Tanshinone IIA Sulfonate Injection on Blood Lipid in Patients With Coronary Heart Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

Front Cardiovasc Med. 2021 Nov 24:8:770746. doi: 10.3389/fcvm.2021.770746. eCollection 2021.

Authors

Hufang Zhou¹, Ying Zhao², Wenhua Peng¹, Wenbo Han³, Zichen Wang¹, Xiaoxia Ren¹, Dayang Wang¹, Guozhong Pan¹, Qian Lin⁴, Xian Wang¹

Affiliations

¹ Cardiovascular Diseases Center, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
² Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
³ Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China.
⁴ Changping District Hospital of Integrated Traditional Chinese and Western Medicine, Beijing, China.

Abstract

Background: Lipid-lowering therapy is very important in secondary prevention of coronary heart disease (CHD). In many clinical trials, it has been found that Sodium Tanshinone IIA Sulfonate Injection (STS) have a lipid-lowering effect while reducing major cardiovascular events in patients with CHD. However, up to now, there is no system review on the effectiveness and safety of STS affecting blood lipids. Purpose: The aim of this review is to systematically assess the effects of STS on blood lipid levels in patients with CHD. Methods: Until Mar 2021, five databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Database) were searched for randomized controlled trials (RCTs) about STS treating patients with CHD. Risk bias was assessed for included studies according to Cochrane handbook. The primary outcome was total cholesterol (TC). The secondary outcomes were triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and adverse events (AEs). Results: A total of 27 trials including 2,445 CHD patients met the eligibility criteria. Most trials had high risks in random sequence generation, allocation concealment, blinding of patients and personal, blinding of outcome assessment. Meta-analysis showed that STS significantly reduced plasma TC levels [MD = -1.34 mmol/l 95% CI (-1.59, -1.09), p < 0.00001, I ² = 98%], TG levels [MD = -0.49 mmol/l 95% CI (-0.62, -0.35), p < 0.00001, I ² = 97%], LDL-c levels [MD = -0.68 mmol/l (-0.80, -0.57), p < 0.00001, I ² = 96%], increased HDL-c levels [MD = 0.26 mmol/l (0.15, 0.37), p < 0.00001, I ² = 97%], without increasing the incidence of AEs [RR = 1.27 95% CI (0.72, 2.27), p = 0.94, I ² = 0%] in patients with CHD. Conclusion: STS can safely and effectively reduce plasma TC, TG and LDL-c levels in patients with CHD, and improve plasma HDL-c levels. However, these findings require careful recommendation due to the low overall quality of RCTs at present. More multi-center, randomized, double-blind, placebo-controlled trials which are designed follow the CONSORT 2010 guideline are needed.

Keywords: Sodium Tanshinone IIA Sulfonate; blood lipid; coronary heart disease; meta-analysis; randomized controlled trials; systematic review.

Publication types

Systematic Review