Table4_Traditional Chinese medicine lowering lipid levels and cardiovascular events across baseline lipid levels among coronary heart disease: a meta-analysis of randomized controlled trials.docx

BackgroundDyslipidemia is a critical driver in the development of coronary heart disease (CHD), which further exacerbates the risk of major adverse cardiovascular events (MACEs). Chinese herbal medicine (CHM) plays an important role in the regulation of lipid levels and improvement of prognosis. However, few systematic reviews report whether the efficacy of CHM therapy for regulating lipid levels and lowering cardiovascular events is associated with baseline lipid levels.MethodsRandomized controlled trials assessing efficacy of CHM for lipid profiles and MACEs among patients with CHD were searched in six databases. Two authors independently extracted studies according to a predesigned form. Cochrane risk of bias tool and Grading of Recommendations Assessment, Development, and Evaluation system were used to assess the methodological quality of the included studies. The primary outcomes were blood lipid levels and MACEs including cardiovascular mortality, non-fatal myocardial infarction, revascularization, angina pectoris, heart failure, and non-fatal stroke across baseline lipid levels. The secondary outcomes were individual components of the primary outcomes.ResultsA total of 23 trials with 7,316 participants were included in this study. Altogether 377 cardiovascular events occurred in 3,670 patients in the CHM group, while 717 events occurred in 3,646 patients in the Western medicine–alone group. Compared with the Western medicine alone, additional CHM significantly lowered low-density lipoprotein cholesterol (LDL-C) [MD = −0.46, 95% CI (−0.60 to −0.32), P

血脂异常是冠心病（CHD）发展的关键驱动力，进而加剧了主要不良心血管事件（MACEs）的风险。中医药（CHM）在调节血脂水平和改善预后方面发挥着重要作用。然而，很少有系统综述报告中医药治疗调节血脂水平及降低心血管事件的效果是否与基线血脂水平相关。方法：在六个数据库中搜索了评估中医药调节血脂和降低冠心病患者MACEs疗效的随机对照试验。两位作者根据预先设计的表格独立提取了研究。采用Cochrane偏倚风险评估工具和推荐评估、开发与评价系统对纳入研究的方法学质量进行了评估。主要结局指标包括基线血脂水平下的血液血脂水平和MACEs，包括心血管死亡率、非致命性心肌梗死、再血管化、心绞痛、心力衰竭和非致命性卒中。次要结局指标为主要结局指标的个人组成部分。结果：共纳入了23项试验，共7,316名参与者。在中医药组中，3,670名患者共发生心血管事件377起，而在仅使用西医组的3,646名患者中，共发生717起事件。与单独使用西医相比，额外使用中医药显著降低了低密度脂蛋白胆固醇（LDL-C）[MD = −0.46，95% CI（−0.60至−0.32），P