META Analysis Of The Efficacy Of L-carnitine In The Treatment Of Coronary Heart Disease

ObjectiveTo evaluate the efficacy of 1-carnitine combined_with conventional drugs in the treatment of coronary heart disease using META-analysis.MethodsBy searching the databases of CNKI,VIP,_Wanfang,Embase,Pubmed and so on.collected literatures are in English and Chinese.We screened literatures that focused on the treatment of coronary heart disease with L-carnitine and published from the establishment of the database to December 2019.All selected papers were randomized controlled trials.Finally,a total of 1,383 cases from 13 of the dissertations were selected,including 710 cases of CHD treated with the combination of L-carnitine and conventional drugs(experimental group),as well as 673 cases of CHD treated with conventional drugs(control group).The data were collected by two or more operators independently.The data in each study included the basic characteristics of the population,relative risk(RR)or mean difference(MD)and 95%confidence interval(CI)between the experimental group and the control group,etc.Depending on whether there is heterogeneity,the data obtained in each study were analyzed using the random effect model and/or fixed effect model,while the case data obtained in the experimental group and the control group were comprehensively evaluated.The basic and clinical baseline data of patients in each group were tested to confirm the normal distribution,and no significant difference was found between the groups.In addition,risk of bias assessment was conducted on the included dissertations.All the collected data were subjected to a meta-analysis using Revman5.3.The efficacy(frequency of angina attack was reduced by more than 50%,ST segment of ECG recovered by more than 0.05 mv,or inverted T waves of ECG leads became shallower by more than 50%)of the experimental group and the control group was compared by combining the effect size.Moreover,the frequency of angina attack,the number of leads showing ST depression(NST)in conventional 12-lead ECG,the mv of ST depression(?ST)in conventional 12-lead ECG and the incidence of adverse reactions were compared between two groups,so as to evaluate the effectiveness and safety of L-carnitine in the treatment of CHD.ResultA total of 13 dissertations meeting the criteria were retrieved,including a total of 1,383 cases,with 710 cases in the experimental group and 673 cases in the control group.The meta-analysis showed that the efficacy of the experimental group was higher than that of the control group[RR=1.18;95%CI(1.12,1.25);P<0.0001].Further subgroup analysis revealed that the experimental group was superior to the control group in reducing the frequency of angina attack[MD=-1.15;95%CI(-1.40,-0.89);P<0.00001]and improving myocardial ischemia(NST[MD=-0.57;95%CI(-1.03,-0.11);P=0.02],?ST[MD=-0.60,95%CI(-0.91,-0.30);P=0.0001]).However,no statistically significant difference was found in the incidence of adverse reactions between both groups[RR=0.71;95%CI(0.26,1.95);P=0.51].ConclusionAccording to META analysis,the effect of treatment of L-carnitine combined with conventional drugs for CHD is better than conventional drugs alone,specially in lower frequency of angina attacks and improvement of myocardial ischemia.