Dose-related efficacy and safety of sodium tanshinone II A sulfonate for the treatment of unstable angina pectoris: a meta-analysis.

Abstract

Introduction: Unstable angina pectoris (UAP), a prevalent form of angina pectoris, is caused by coronary artery stenosis, elevated blood viscosity, and atheromatous plaque that blocks blood vessels. A meta-analysis was conducted to evaluate the efficacy and safety of various injectable doses of sodium tanshinone II A sulfonate (STS) for UAP treatment.

Evidence acquisition: The Web of Science, CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, and Embase databases were used to search for randomized controlled trials (RCTs) using STS until December 29^th, 2023. The selection of studies solely focused on conventional Western medicine (WM) and different STS dosages (40, 50, 60, or 80 mg/day) combined with WM. The risk of bias was evaluated using the Quality in Prognostic Studies (QUIPS) tool. The standardized mean difference (SMD) or risk ratio (RR) was used to develop the random-effects or fixed-effects model.

Evidence synthesis: The study included 31 RCTs. The results of the meta-analysis showed that compared with WM alone, combination of WM and STS at 40 mg/day (RR: 1.15 [95% CI: 1.03, 1.29]; P=0.027) or 60 mg/day (RR: 1.20 [95% CI: 1.11, 1.30]; P=0.0005) increased electrocardiographic efficacy. Compared with WM alone, 40 mg/day of STS plus WM reduced plasma viscosity (SMD: -0.78 [95% CI: -1.60, 0.04]; P=0.056); whole blood low viscosity (SMD: -0.58 [95% CI: -0.95, -0.21]; P=0.015); CRP (SMD: -1.07 [95% CI: -2.10, -0.03]; P=0.047); and adverse events (SMD: -1.62 [95% CI: -3.55, 0.31]; P=0.069). In addition to 40 mg of STS, we found that 60 mg of STS plus WM reduced the incidence of adverse events (SMD: -1.01 [95% CI: -2.07, 0.04]; P=0.055).

Conclusions: This meta-analysis indicated that the combination of STS on 40 mg/day with WM enhanced the safety and clinical efficacy of UAP therapy.