Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis

ObjectiveAcupuncture combined with multiple treatment modalities has been widely employed for treating angina pectoris. This paper compared the efficacy of acupuncture combined with multiple treatment modalities for angina pectoris by network meta-analysis (NMA).MethodsAs of November 2023, this stud...

Full description

Saved in:
Bibliographic Details
Main Authors: Xiangyu Kong, You Gu, Zhao Qiu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2025.1463170/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832582024630632448
author Xiangyu Kong
You Gu
Zhao Qiu
author_facet Xiangyu Kong
You Gu
Zhao Qiu
author_sort Xiangyu Kong
collection DOAJ
description ObjectiveAcupuncture combined with multiple treatment modalities has been widely employed for treating angina pectoris. This paper compared the efficacy of acupuncture combined with multiple treatment modalities for angina pectoris by network meta-analysis (NMA).MethodsAs of November 2023, this study searched eight electronic databases for randomized controlled trials (RCTs) of acupuncture combined with multiple modalities for the treatment of angina pectoris based on antianginal therapies. Primary efficacy indicators included the number of angina episodes and duration of episodes, and secondary indicators included clinical efficacy based on symptom improvement and electrocardiographic efficacy based on ST-segment and T-wave improvement. The Cochrane Risk of Bias tool 2.0 (RoB 2.0) was used for risk of bias assessment. A random-effects Bayesian NMA was performed using R (version 4.3.1) and Stata (version 16.0).Results46 RCTs were enrolled, with 3976 patients with angina pectoris. In reducing the number of angina episodes, acupuncture [MD: −3.79; 95% CrI (−6.34, −1.31)] and acupuncture + TCM [MD: −3.06; 95% CrI (−5.49, −0.62)] were superior to antianginal therapies, with acupuncture having the best efficacy (SUCRA: 78.2%). In shortening the duration of angina episodes, electroacupuncture (EA) + traditional Chinese medicine (TCM) was the most effective (SUCRA: 95.1%), superior to antianginal therapies [MD: −5.04; 95% CrI (−9.18, −0.89)], adjunctive therapy [MD: 7; 95% CrI (1.58, 12.39)], rehabilitation therapy [MD: −5.38; 95% CrI (−10.75, −0.05)], and warm acupuncture + adjunctive therapy [MD: −6.71; 95% CrI (−13, −0.48)]. In terms of clinical efficacy, thumbtack needling had the best efficacy (SUCRA: 82.1%), superior to TCM [RR: 1.3; 95% CrI (1.02, 1.69)] and antianginal therapies [RR: 0.75; 95% CrI (0.6,0.91)]. In electrocardiographic efficacy, EA showed the best efficacy (SUCRA: 92.9%), superior to antianginal therapies [RR: 0.52; 95% CrI (0.35, 0.71)] and acupuncture [RR: 0.62; 95% CrI (0.39, 0.91)].ConclusionAcupuncture performs best in reducing anginal episodes; EA + TCM is the most effective in shortening the duration of anginal episodes; thumbtack needling is the most effective in clinical efficacy; and EA shows optimal results in electrocardiographic efficacy. To further validate these findings, multicenter and large-sample RCTs are needed.Systematic Review RegistrationPROSPERO [CRD42024505456].
format Article
id doaj-art-59379accd07349da972e7a19dae5cc81
institution Kabale University
issn 2297-055X
language English
publishDate 2025-01-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Cardiovascular Medicine
spelling doaj-art-59379accd07349da972e7a19dae5cc812025-01-30T06:22:07ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2025-01-011210.3389/fcvm.2025.14631701463170Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysisXiangyu Kong0You Gu1Zhao Qiu2Department of Traditional Chinese Medicine, Shanyang Town Community Health Service Center, Shanghai, ChinaDepartment of Traditional Chinese Medicine, Shanghai Pudong Hospital, Shanghai, ChinaDepartment of Rehabilitation Medicine, Shanyang Town Community Health Service Center, Shanghai, ChinaObjectiveAcupuncture combined with multiple treatment modalities has been widely employed for treating angina pectoris. This paper compared the efficacy of acupuncture combined with multiple treatment modalities for angina pectoris by network meta-analysis (NMA).MethodsAs of November 2023, this study searched eight electronic databases for randomized controlled trials (RCTs) of acupuncture combined with multiple modalities for the treatment of angina pectoris based on antianginal therapies. Primary efficacy indicators included the number of angina episodes and duration of episodes, and secondary indicators included clinical efficacy based on symptom improvement and electrocardiographic efficacy based on ST-segment and T-wave improvement. The Cochrane Risk of Bias tool 2.0 (RoB 2.0) was used for risk of bias assessment. A random-effects Bayesian NMA was performed using R (version 4.3.1) and Stata (version 16.0).Results46 RCTs were enrolled, with 3976 patients with angina pectoris. In reducing the number of angina episodes, acupuncture [MD: −3.79; 95% CrI (−6.34, −1.31)] and acupuncture + TCM [MD: −3.06; 95% CrI (−5.49, −0.62)] were superior to antianginal therapies, with acupuncture having the best efficacy (SUCRA: 78.2%). In shortening the duration of angina episodes, electroacupuncture (EA) + traditional Chinese medicine (TCM) was the most effective (SUCRA: 95.1%), superior to antianginal therapies [MD: −5.04; 95% CrI (−9.18, −0.89)], adjunctive therapy [MD: 7; 95% CrI (1.58, 12.39)], rehabilitation therapy [MD: −5.38; 95% CrI (−10.75, −0.05)], and warm acupuncture + adjunctive therapy [MD: −6.71; 95% CrI (−13, −0.48)]. In terms of clinical efficacy, thumbtack needling had the best efficacy (SUCRA: 82.1%), superior to TCM [RR: 1.3; 95% CrI (1.02, 1.69)] and antianginal therapies [RR: 0.75; 95% CrI (0.6,0.91)]. In electrocardiographic efficacy, EA showed the best efficacy (SUCRA: 92.9%), superior to antianginal therapies [RR: 0.52; 95% CrI (0.35, 0.71)] and acupuncture [RR: 0.62; 95% CrI (0.39, 0.91)].ConclusionAcupuncture performs best in reducing anginal episodes; EA + TCM is the most effective in shortening the duration of anginal episodes; thumbtack needling is the most effective in clinical efficacy; and EA shows optimal results in electrocardiographic efficacy. To further validate these findings, multicenter and large-sample RCTs are needed.Systematic Review RegistrationPROSPERO [CRD42024505456].https://www.frontiersin.org/articles/10.3389/fcvm.2025.1463170/fullacupuncturemultiple therapiesangina pectorissystematic reviewnetwork meta-analysis
spellingShingle Xiangyu Kong
You Gu
Zhao Qiu
Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
Frontiers in Cardiovascular Medicine
acupuncture
multiple therapies
angina pectoris
systematic review
network meta-analysis
title Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
title_full Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
title_fullStr Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
title_full_unstemmed Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
title_short Acupuncture combined with multiple therapies for angina pectoris: a systematic review and network meta-analysis
title_sort acupuncture combined with multiple therapies for angina pectoris a systematic review and network meta analysis
topic acupuncture
multiple therapies
angina pectoris
systematic review
network meta-analysis
url https://www.frontiersin.org/articles/10.3389/fcvm.2025.1463170/full
work_keys_str_mv AT xiangyukong acupuncturecombinedwithmultipletherapiesforanginapectorisasystematicreviewandnetworkmetaanalysis
AT yougu acupuncturecombinedwithmultipletherapiesforanginapectorisasystematicreviewandnetworkmetaanalysis
AT zhaoqiu acupuncturecombinedwithmultipletherapiesforanginapectorisasystematicreviewandnetworkmetaanalysis