Efficacy and safety of traditional Chinese medicine on thromboembolic events in patients with atrial fibrillation: A systematic review and meta-analysis |
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| Institution: | 1. Department of Cardiology, The Fifth People’s Hospital of Shanghai, Fudan University, 801, Heqing Rd, Minhang District, Shanghai 200240, China;2. Shanghai Minhang Center for Disease Control and Prevention, Shanghai 201101, China;3. Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 180, fenglin Road, Xuhui District, Shanghai 200032, China;1. Chair of Research Methodology and Statistics in Psychology, Department of Psychology and Psychotherapy, Faculty of Health, University of Witten-Herdecke, Witten, Germany;2. Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, Australia;3. Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany;1. Department of Public Health, China Medical University, Taichung, Taiwan;2. Department of Nursing, Show Chwan Memorial Hospital, Changhua City, Taiwan;3. Department of Pathology, Show Chwan Memorial Hospital, Changhua City, Taiwan;4. School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan;5. School of Nursing, College of Health Care, China Medical University, Taichung, Taiwan;6. Department of Nursing, China Medical University Hospital, Taichung, Taiwan;7. Graduate Institute of Chinese Medical Science, College of Chinese Medicine, China Medical University, Taichung, Taiwan;8. Department of Brest surgery, Show Chwan Memorial Hospital, Changhua City, Taiwan;1. Department of Acupuncture and moxibustion, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China;2. Department of Chinese Orthopedics and Traumatology, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China;3. Department of Gastroenterology, Zhongda Hospital, School of medicine, Southeast University, Nanjing 210009, China;1. Division of Life Science and Centre for Chinese Medicine, The Hong Kong University of Science and Technology, Clear Water Bay Road, Hong Kong, China;2. Xinjiang Key Laboratory of Plant Resources and Natural Products Chemistry, Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Urumqi 830011, China;1. Shihezi University, Shihezi, Xinjiang 832000, PR China;2. Graduate student office, Shihezi University, Shihezi, Xinjiang 832000, PR China;3. Yili Friendship Hospital, Yining, Xinjiang 835000, PR China |
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| Abstract: | ObjectivesTraditional Chinese medicine (TCM) in combination with Western medicine (WM) has been widely used worldwide. This systematic review aimed to evaluate the efficacy and safety of TCM in prevention of thromboembolic events in patients with atrial fibrillation (AF).MethodsPotential studies were searched through the Cochrane Library, PubMed, EMBASE, CBM, VIP, CNKI, and Wanfang databases up to February 2016. Randomized controlled trials (RCTs) investigating the thromboembolic events and/or safety outcome of TCM in patients with AF were included.ResultsA total of 905 AF patients from 9 RCTs were identified. Meta-analysis showed that TCM in combination with warfarin was better than warfarin alone for preventing total thromboembolic events with a 68% reduction of risk (risk ratio RR] 0.32; 95% confidence interval CI] 0.13–0.78) without increasing the risk of total bleeding (RR 0.71; 95% CI 0.29–1.72). Compared with warfarin, TCM therapy was associated with lower risk of total bleeding (RR 0.13; 95% CI 0.04–0.47), but increased the risk of total thromboembolic events (RR 1.84; 95% CI 1.03–3.27).ConclusionsThis meta-analysis suggests that TCM combined with warfarin is superior to warfarin alone for the prevention of total thromboembolic events in patients with AF, with equal risk of bleeding as warfarin alone. |
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| Keywords: | Atrial fibrillation Warfarin Bleeding Thromboembolic events Meta-analysis |
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