Wenxin Keli for Ventricular premature complexes with Heart failure: A Systematic Review and Meta-Analysis of Randomized Clinical Trials

•Wenxin Keli used for ventricular premature complexes with heart failure was systematically reviewed.•Wenxin Keli used alone or in combination with Western medicine appears to be more effective.•Wenxin Keli therapy seems to be safe.•Through this systematic review, we found some points to suggest that clinical trials in the future should pay attention to. At first, choose adequate random methods and hide the dividing project to assure comparability and reduce selective bias. Double blind or triple blind should be used. Secondly, the intervention time of drugs should be extended. Thirdly, observed indexes should also contain incident rate of cardiovascular events and mortality. Finally, clinical trial overseas should be carried out to observe individual difference between regions, etc.

ObjectiveTo evaluate the efficacy and safety of Wenxin Keli (WXKL) alone or combined with Western medicine in treating ventricular premature complexes (VPCs) with heart failure (HF).MethodsWe searched five databases to identify relevant randomized controlled trials (RCTs) published before May 2016. Two review authors independently searched and screened the literature, extracted the data as well as assessed the methodological quality of the included studies by using criteria from the Cochrane Handbook, and analyzed via using Review Manager 5.3 software.ResultsEight studies of WXKL were included. The results of the Meta-analysis showed that WXKL was more significant on the frequency of VPCs (MD = −427.08, 95% CI: −526.73 ∼ −327.43, P < 0.01), left ventricular ejection fraction (LVEF) (MD = −4.12, 95% CI: 2.97 ∼ 5.27, P < 0.01), the total effect of VPCs (RR = 0.48, 95% CI: 0.34 ∼ 0.69, P < 0.01) and 6-min walking test (MD = 28.05, 95% CI: 19.56 ∼ 36.54, P < 0.01). The treatment group presented a significant reduction at left ventricular end-diastolic diameter (LVED) (MD = −3.94, 95% CI: −6.57 ∼ −1.31, P < 0.01) when treatment time was 12 weeks, however, there was no statistical difference at 8 weeks. In addition, the included trials generally showed low methodological quality.ConclusionsWenxin Keli may be effective and safe for treating VPCs and HF. However, further RCTs of larger scale, multi-center/country, longer follow-up periods, and higher quality are still required to verify the efficacy of Wenxin Keli in ventricular premature beat with heart failure.