Angina pectoris has a prevalence of 3-4% in Western countries and is the most common manifestation of ischaemic heart disease and the leading cause of death worldwide. Paroxysmal chest pain or chest discomfort caused by the insufficient blood supply to the coronary artery, rapid temporary ischemia, and hypoxia of the myocardium are the common characteristic features of angina pectoris. Stable angina pectoris (SA), unstable angina pectoris (UA), and variable angina pectoris (VA) are the three types of angina based on the mechanism and attack status. In both men and women, the prevalence of angina is found to increase with age. β-blockers, nitrates, coronary artery dilators, calcium channel blockers and antiplatelet drugs are primarily used in the treatment of angina pectoris. To establish evidence-based medical grounds for its clinical application, the safety and effectiveness of Sofren injection, an anti-ischaemic and anti-inflammatory agent, was reviewed.
Methods: Embase, PubMed, VIP, Cochrane Library, CNKI, Wanfang and China biomedical databases were used to collect details of randomised controlled trials (RCTs) of angina treated with Sofren injection combined with conventional Western medicine. The RevMan5.3 software was used for the statistical analysis of data. The literature research led to 22 studies with a total of 2,167 patients. About 1,077 and 1,090 cases were present in the control and observation groups, respectively.
Results: Significant heterogeneity among results (P = 0.04, I² = 68%) was observed in the literature studying blood platelet aggregation rate, indicating a better effect of Sofren injection in patients. A statistically significant difference (MD = -2.07, 95% CI (−2.43, −1.71), P < 0.00001) was noted when the random-effects model was adopted for meta-analysis of studies recording plasma plasminogen activator inhibitor 1, thereby establishing a better action of Sofren injection. A statistically significant difference (MD = −10.16, 95% CI (−13.11, −7.20), P < 0.00001) was seen when the fixed-effect model was adopted for meta-analysis of studies documenting Thromboxane B2, again proving the better effect obtained by Sofren injection.
Discussion: Patients with angina pectoris receiving a combination of Sofren injection and Western medicine showed more improvement in attack duration, electrocardiogram, platelet function, blood rheology, and serum factor effect than the control group. Sofren injection can decrease whole blood viscosity, improve the function of platelets, inhibit thrombosis, and relieve the symptoms of angina pectoris due to its ingredients like tyrosol, polysaccharide and rhodiola glucoside that dilate the coronary arteries and improve ischaemic tissue. Also, there is no significant difference in adverse reaction incidence; however, further validation is needed.
Conclusion: A combination of Sofren injection and Western medicine can be used for the effective treatment of angina pectoris. Nevertheless, for even better clinical guidance, the effectiveness and safety of Sofren injection and the incidence of adverse reactions need to be evaluated in high-quality RCTs.