Abstract
OBJECTIVE: To evaluate the efficacy of Compound Danshen Dripping Pills (CDDP) combined with isosorbide mononitrate (ISMN) versus ISMN alone for treating angina pectoris in patients. METHODS: The PubMed, Web of Science, Cochrane Library, Embase China National Knowledge Infrastructure, China Biomedical Literature Service System, Chinese Medical Journal Database, and Wan Fang MED databases were searched from inception to November 2022. Randomized controlled trials (RCTs) and cohort studies were included. The primary outcomes were angina symptom and electrocardiography (ECG) efficacy, angina symptom efficacy, and ECG efficacy. The protocol was registered with PROSPERO No. CRD42022314774. RESULTS: Our study included 7 245 patients with angina (59 RCTs, 11 cohort studies). When ISMN was combined with CDDP, the efficacy of angina symptom and ECG [odds ratio (OR) = 4.824, 95% confidence interval (CI) = 3.636-6.401, P = 0.000], the efficacy of angina symptom (OR = 4.347, 95% CI = 3.635-5.198, P = 0.000), the efficacy of ECG (OR = 3.364, 95% CI = 2.767-4.089, P = 0.000) were better than that of patients treated with ISMN alone. CDDP combined with ISMN was superior to ISMN alone in reducing triglyceride (TG) [mean difference (MD) = -35.176, 95% CI = -37.439 to -32.912, P = 0.000], total cholesterol (TC) (MD = -24.296, 95% CI = -26.429 to -22.163, P = 0.000), the duration of angina attack (MD = -1.991, 95% CI = -2.349 to -1.633, P = 0.000), and the frequency of angina attack [standardized MD (SMD) = -2.840, 95% CI = -3.416 to -2.265, P = 0.000]. There was no increase in adverse events between CDDP combined with ISMN and ISMN alone (OR = 0.513, 95% CI = 0.421-0.626, P = 0.000). CONCLUSION: CDDP combined with ISMN improved treatment efficacy and was well tolerated. Therefore, this combination could be used as an alternative treatment. However, clinical and patient conditions should be considered.