Astragalus Granule plus Western medicine ranked best for overall clinical efficacy in heart failure

This systematic review and network meta-analysis assessed the efficacy and safety of oral traditional Chinese medicines containing Astragalus alone or in combination with other drugs compared to Western medicine alone in patients with heart failure. The analysis included a total sample size of 1584 patients. The study setting details were not reported in the provided data. The review examined multiple specific interventions including Astragalus Granule, Qiangxin Capsule, Yanxing Decoction, Xinlishen Compound, Qili Qiangxin Capsule, and Yangxin Tongmai II Prescription. The comparator group consisted of patients receiving Western medicine alone. The primary outcome measured was the overall clinical efficacy rate. Secondary outcomes included the six-minute walk test, B-type natriuretic peptide levels, N-terminal pro-B-type natriuretic peptide levels, left ventricular ejection fraction, left ventricular end-diastolic diameter, and Minnesota Heart Failure Quality of Life Questionnaire scores.

Regarding the primary outcome, Astragalus Granule combined with Western medicine ranked best compared to using Western medicine alone. The specific effect size, absolute numbers, and p-value or confidence interval for this primary outcome were not reported in the input data. For the secondary outcome of the six-minute walk test, Qiangxin Capsule combined with Western medicine was optimal. The specific effect size, absolute numbers, and p-value or confidence interval for this result were not reported. In terms of B-type natriuretic peptide levels, Astragalus Granule combined with Western medicine showed the best efficacy for reducing levels. The specific effect size, absolute numbers, and p-value or confidence interval for this reduction were not reported.

For N-terminal pro-B-type natriuretic peptide levels, Yanxing Decoction combined with Western medicine ranked first for lowering levels. The specific effect size, absolute numbers, and p-value or confidence interval for this finding were not reported. When evaluating left ventricular ejection fraction, Xinlishen Compound combined with Western medicine was the optimal combination for improving this metric. The specific effect size, absolute numbers, and p-value or confidence interval for this improvement were not reported. For left ventricular end-diastolic diameter, Qili Qiangxin Capsule combined with Western medicine performed best for reducing this measurement. The specific effect size, absolute numbers, and p-value or confidence interval for this reduction were not reported. Finally, regarding Minnesota Heart Failure Quality of Life Questionnaire scores, Yangxin Tongmai II Prescription combined with Western medicine exhibited the highest efficacy for decreasing scores. The specific effect size, absolute numbers, and p-value or confidence interval for this decrease were not reported.

Safety and tolerability findings were not reported in the input data. Adverse events were not reported. Serious adverse events were not reported. Discontinuations were not reported. Tolerability was not reported. The study limitations included a limited number and quality of the included studies. Funding or conflicts of interest were not reported. The practice relevance indicates that adding oral traditional Chinese medicine containing Astragalus to Western medicine treatment can further improve the clinical efficacy of heart failure. However, causality notes state that conclusions still require further validation through well-designed randomized double-blind controlled trials. The certainty note highlights that due to the limited number and quality of the included studies, the evidence is uncertain. The input data explicitly lists that conclusions require further validation and advises against overstating the findings.