Evaluation of the safety and efficacy of Zhenwu decoction as adjuvant therapy for the treatment of heart failure with reduced ejection fraction: A protocol for systematic review and meta-analysis.

Introduction: Heart failure with reduced ejection fraction (HFrEF) demonstrates a substanital threat to global public health. Several Chinese studies have been conducted to date evaluating the clinical efficacy of Zhenwu decoction (ZWD) as a treatment for HFrEF. The present systematic review will be conducted to more comprehensively evaluate the impact of ZWD on HFrEF outcomes.

Methods: For this systematic review, all randomized controlled trials (RCTs) reporting on the effectiveness of ZWD as a treatment for HFrEF published as of December 30, 2021 in the Embase, PubMed, Springer, Web of Science, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure, and the Wan-Fang databases will be identified without any language or publication restrictions. Two researchers will independently choose investigations, extract information, and gauge research quality. Primary outcomes of interest will include all-cause mortality and HF-associated mortality. Secondary outcomes will include the incidence of adverse events, ultrasonic cardiographic indices (including left ventricular ejection fraction and left ventricular mass index), New York Heart Association grade, N-terminal pro-b-type natriuretic peptide, B-type natriuretic peptide, and 6-minute walking distance. RevMan v 5.3 will be used to conduct meta-analyses where possible, with descriptive or subgroup analyses otherwise being conducted. Data will be given as risk ratios for categorical variables and mean difference for continuous variables.

Results: This comprehensive protocol will aid in the systematic and objective evaluation of the efficacy and safety of ZWD as a treatment for HFrEF, providing a scientific basis for the clinical utilization of ZWD.