Efficacy and safety of integrated traditional Chinese medicine and standard Western medicine for patients with acute coronary syndrome: protocol for a systematic review and meta-analysis

Background: Acute coronary syndrome (ACS), which usually results from the buildup of fatty deposits (plaques) in and on the walls of coronary arteries, remains a major cause of morbidity and mortality worldwide. In the present systematic review, we aim to evaluate the efficacy and safety of adding traditional Chinese medicine (TCM) to standard western medicine to treat patients with ACS. Methods: A systematic search was carried out in the China National Knowledge Infrastructure (CNKI; Chinese), the Chinese Biomedical Literature Disk Database CBMdisc (Chinese), Wanfang Data (Chinese), PubMed, Embase, and Web of Science for relevant papers up to January 20, 2021. All published randomized controlled trials related to the integration of TCM and Western medicine for ACS will be included. The primary outcome is the effective rate and cardiovascular function index (left ventricular ejection fraction, early peak flow velocity, and thrombolysis in myocardial infarction). The secondary outcome is blood lipid level (total cholesterol, triacylglycerol, low/high density lipoprotein) and the incidence of adverse cardiovascular events. Study selection, data collection, and quality evaluation will be conducted by 2 reviewers independently. Comprehensive meta-analyses together with sensitivity and subgroup analyses will be performed with Stata 15.0 software (StataCorp). Discussion: The results will provide a high-quality guidance for the current clinical treatment of ACS, and the patients more options to relieve their symptoms. The findings from this study may provide updated evidence concerning the efficacy and safety of TCM for patients with ACS.