Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials

BackgroundInflammatory factors and vascular endothelial damage are significantly involved in the development of unstable angina pectoris (UAP). Danhong injection (DHI) is a compound injection composed of Salvia miltiorrhiza and Carthamus tinctorius extracts. Several clinical studies have demonstrate...

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Main Authors: Zunqi Kan, Wenli Yan, Cong Chen, Huanyu Gao, Yongmei Song
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1389746/full
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author Zunqi Kan
Wenli Yan
Cong Chen
Huanyu Gao
Yongmei Song
author_facet Zunqi Kan
Wenli Yan
Cong Chen
Huanyu Gao
Yongmei Song
author_sort Zunqi Kan
collection DOAJ
description BackgroundInflammatory factors and vascular endothelial damage are significantly involved in the development of unstable angina pectoris (UAP). Danhong injection (DHI) is a compound injection composed of Salvia miltiorrhiza and Carthamus tinctorius extracts. Several clinical studies have demonstrated DHI’s efficacy for treating UAP, with potential pharmacological effects on inflammatory factors and vascular endothelial function. However, to date, the current evidence has not been systematically summarized and analyzed.PurposeThis study provides a comprehensive overview of the most recent clinical findings and systematically analyzes the impact of DHI on inflammatory factors and vascular endothelial function among individuals diagnosed with UAP.MethodsWe searched for randomized controlled trials (RCTs) conducted until January 2023 from two clinical trial registries and eight literature databases. The Cochrane Risk of Bias Tool 2.0 was utilized to assess the potential bias in the included trials, while the GRADE system was employed to evaluate the outcome quality.ResultsWe included 46 trials involving 4,601 patients with UAP. The meta-analysis results suggested that DHI significantly reduced the levels of high-sensitivity C-reactive protein (hs-CRP) (standard mean difference [SMD] = 1.34, 95% confidence interval [CI] [-1.77, −0.90], P < 0.00001), tumor necrosis factor-alpha (TNF-α) (SMD = −0.84, 95% CI [-1.54, −0.15], P = 0.02), interleukin-6 (IL-6) (SMD = −1.05, 95% CI [-1.86, −0.25], P = 0.01), endothelin/endothelin-1 (ET/ET-1) (SMD = −2.01, 95% CI [-2.57, −1.46], P < 0.00001), and homocysteine (Hcy) (SMD = −0.55, 95% CI [-0.71, −0.39], P < 0.00001) but increased the nitric oxide (NO) level (SMD = 1.51, 95% CI [1.04, 1.97], P < 0.00001) in patients with UAP. Twenty-one RCTs described adverse events.ConclusionDHI effectively and safely reduced hs-CRP, TNF-α, IL-6, ET/ET-1, and Hcy levels and increased the NO level in patients with UAP. However, considering the overall low quality of the original studies, future large-scale, high-quality RCTs are imperative to provide robust evidence for clinical practice.Systematic Review Registrationidentifier CRD42023391497.
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spelling doaj-art-0021da279e5c47d8b43f5bafb594ed602025-08-20T02:33:34ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-06-011610.3389/fphar.2025.13897461389746Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trialsZunqi Kan0Wenli Yan1Cong Chen2Huanyu Gao3Yongmei Song4Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, ChinaSchool of Acupuncture-Moxibustion and Tuina, International Acupuncture and Moxibustion Innovation Institute, Beijing University of Chinese Medicine, Beijing, ChinaInstitute for Literature and Culture of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaInstitute for Literature and Culture of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaInstitute for Literature and Culture of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, ChinaBackgroundInflammatory factors and vascular endothelial damage are significantly involved in the development of unstable angina pectoris (UAP). Danhong injection (DHI) is a compound injection composed of Salvia miltiorrhiza and Carthamus tinctorius extracts. Several clinical studies have demonstrated DHI’s efficacy for treating UAP, with potential pharmacological effects on inflammatory factors and vascular endothelial function. However, to date, the current evidence has not been systematically summarized and analyzed.PurposeThis study provides a comprehensive overview of the most recent clinical findings and systematically analyzes the impact of DHI on inflammatory factors and vascular endothelial function among individuals diagnosed with UAP.MethodsWe searched for randomized controlled trials (RCTs) conducted until January 2023 from two clinical trial registries and eight literature databases. The Cochrane Risk of Bias Tool 2.0 was utilized to assess the potential bias in the included trials, while the GRADE system was employed to evaluate the outcome quality.ResultsWe included 46 trials involving 4,601 patients with UAP. The meta-analysis results suggested that DHI significantly reduced the levels of high-sensitivity C-reactive protein (hs-CRP) (standard mean difference [SMD] = 1.34, 95% confidence interval [CI] [-1.77, −0.90], P < 0.00001), tumor necrosis factor-alpha (TNF-α) (SMD = −0.84, 95% CI [-1.54, −0.15], P = 0.02), interleukin-6 (IL-6) (SMD = −1.05, 95% CI [-1.86, −0.25], P = 0.01), endothelin/endothelin-1 (ET/ET-1) (SMD = −2.01, 95% CI [-2.57, −1.46], P < 0.00001), and homocysteine (Hcy) (SMD = −0.55, 95% CI [-0.71, −0.39], P < 0.00001) but increased the nitric oxide (NO) level (SMD = 1.51, 95% CI [1.04, 1.97], P < 0.00001) in patients with UAP. Twenty-one RCTs described adverse events.ConclusionDHI effectively and safely reduced hs-CRP, TNF-α, IL-6, ET/ET-1, and Hcy levels and increased the NO level in patients with UAP. However, considering the overall low quality of the original studies, future large-scale, high-quality RCTs are imperative to provide robust evidence for clinical practice.Systematic Review Registrationidentifier CRD42023391497.https://www.frontiersin.org/articles/10.3389/fphar.2025.1389746/fullDanhong injectionunstable angina pectorisinflammatory factorsvascular endothelial functionmeta-analysis
spellingShingle Zunqi Kan
Wenli Yan
Cong Chen
Huanyu Gao
Yongmei Song
Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
Frontiers in Pharmacology
Danhong injection
unstable angina pectoris
inflammatory factors
vascular endothelial function
meta-analysis
title Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
title_full Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
title_fullStr Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
title_full_unstemmed Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
title_short Efficacy and safety of Danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris: a systematic review and meta-analysis of randomized clinical trials
title_sort efficacy and safety of danhong injection on inflammatory factors and vascular endothelial function in patients with unstable angina pectoris a systematic review and meta analysis of randomized clinical trials
topic Danhong injection
unstable angina pectoris
inflammatory factors
vascular endothelial function
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1389746/full
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