DataSheet_1_Comparative Efficacy of Danshen Class Injections for Treating Acute Coronary Syndrome: A Multidimensional Bayesian Network Meta-Analysis of Randomized Controlled Trials.docx

BackgroundAcute coronary syndrome, that is a common and serious cardiovascular disease, imposes a huge economic burden on global public health. And Danshen class injections are commonly used in the treatment of acute coronary syndrome in China. Thus, the Bayesian network meta-analysis was devised to investigate the efficacy of different Danshen class injections against acute coronary syndrome.
MethodsEligible inclusion and exclusion criteria were established in advance. Then, a systematic literature search was performed in several databases from inception to February 2020. Further, the included randomized controlled trials data were adopted to calculation, prepare graphs and multidimensional cluster analysis by WinBUGS 1.4.3, Stata V.13.0 and R 3.6.1 software, respectively.
ResultsA total of 53 eligible randomized controlled trial studies with 6401 patients were obtained that evaluated the clinical effectiveness rate, the level of hypersensitive C-reactive protein, C-reactive protein, interleukin-6, fibrinogen, and adverse reactions after the application of Danshen class injections plus western medicine. Compared with western medicine alone, Danshen class injections combined with western medicine therapy were associated with significantly improved the therapeutic effect. In addition, the results of the multidimensional cluster analysis demonstrated that Danhong injection + western medicine and Danshen injection + western medicine had better therapeutic effects. However, since most eligible randomized controlled trial studies did not focus on the monitoring of adverse reactions, the safety of these Chinese herbal injections needs to be further explored.
ConclusionBased on this Bayesian network meta-analysis results, Danhong injection + western medicine and Danshen injection + western medicine might have a better impact on acute coronary syndrome patients. Nevertheless, more large samples, high-quality clinical and multicenter randomized controlled trial studies should be tested and verified in the future.

背景 急性冠状动脉综合征（acute coronary syndrome）是一类常见且危重的心血管疾病，给全球公共卫生带来了沉重的经济负担。丹参类注射剂是我国治疗急性冠状动脉综合征的常用药物，因此本研究开展贝叶斯网络元分析（Bayesian network meta-analysis），以探究不同丹参类注射剂治疗急性冠状动脉综合征的临床疗效。
方法 本研究预先制定了合格的纳入与排除标准，随后在多个数据库中从建库至2020年2月进行系统性文献检索。最终纳入的随机对照试验（randomized controlled trial）数据分别采用WinBUGS 1.4.3、Stata V.13.0及R 3.6.1软件进行统计计算、绘图及多维聚类分析。
结果 最终纳入53项合格的随机对照试验，共涉及6401例患者，评估了丹参类注射剂联合西药治疗后的临床有效率、超敏C反应蛋白、C反应蛋白、白细胞介素-6、纤维蛋白原水平及不良反应发生情况。与单纯西药治疗相比，丹参类注射剂联合西药治疗可显著提升临床疗效。多维聚类分析结果显示，丹红注射液联合西药与丹参注射液联合西药的治疗效果更优。但由于多数纳入的随机对照试验未关注不良反应监测，此类中药注射剂的安全性仍有待进一步探究。
结论 基于本次贝叶斯网络元分析结果，丹红注射液联合西药与丹参注射液联合西药或可更好地改善急性冠状动脉综合征患者的临床结局。然而未来仍需开展更多大样本、高质量的多中心随机对照试验进行验证。