Qili Qiangxin capsules for chronic heart failure: A GRADE-assessed clinical evidence and preclinical mechanism.

ABSTRACT

Introduction: Chronic heart failure (CHF) has become an increasing concern with the aging of the population. This study aims to evaluate the effectiveness and safety of Qili Qiangxin capsules (QLQX) for CHF. Methods: A systematic review and meta-analysis on clinical studies was conducted. The mechanisms of preclinical studies were summarized. Results: We searched six electronic databases by 20 July 2022, and finally, 7 preclinical experiments (PEs) and 24 randomized controlled trials were included. The risk of bias was accessed by the SYRCLE and RoB 2.0 tool, respectively. PEs indicated that QLQX suppresses myocardial apoptosis, inhibits renin-angiotensin-aldosterone system activation, improves water retention, and enhances cardiocyte remodeling. In clinical studies, compared with routine treatment, QLQX could improve the indicators clinical efficacy rate (RR = 1.16, 95% CI [1.12, 1.22], GRADE moderate), left ventricular end-diastolic dimension (SMD = -1.04, 95% CI [-1.39, -0.70], GRADE low), left ventricular ejection fraction (SMD = 1.20, 95% CI [0.97, 1.43], GRADE moderate), 6-minute walk distance (SMD = 1.55, 95% CI [0.89, 2.21], GRADE low), brain natriuretic peptide (SMD = -0.78, 95% CI [-1.06, -0.51], GRADE low), N-terminal pro-brain natriuretic peptide (SMD = -2.15, 95% CI [-3.60, -0.71], GRADE low), and adverse events (RR = 0.46, 95% CI [0.25, 0.87], GRADE low). Discussion: In summary, QLQX exerts a potential mechanism of utility on myocardial apoptosis and cardiac function and has noteworthy clinical adjuvant efficacy and safety in patients with CHF. Systematic review registration https//www.crd.york.ac.uk/prospero/.