Background: Danshen [Salvia miltiorrhiza Bunge (Lamiaceae; Salviae miltiorrhizae radix et rhizoma)] class injections (DSCIs) are widely used in the treatment of coronary heart disease (CHD). However, there are various types of DSCIs available on the market, and it remains uncertain which DSCI has the best clinical efficacy, as well as which one is most effective in regulating inflammatory markers and oxidative stress indicators. The aim of this network meta-analysis (NMA) is to compare the therapeutic effects of different DSCIs to identify the optimal DSCI for the treatment of CHD.Methods: The databases searched to identify randomized controlled trials (RCTs) of DSCIs for CHD included the China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, Web of Science, and Cochrane Library. The search period spanned from the inception of each database up to June 2024. NMA was conducted using RevMan 5.3 and Stata 16.0 software.Results: A total of 106 studies including 14,979 patients, involving 10,931 patients, with 5,640 in the experimental group and 5,291 in the control group. And ten DSCIs were extracted, namely: Danhong injection (DH), Danshen injection (DS), Danshenchuanxiongqin injection (DSCXQ), Dansenduofensuanyan injection (DSDFSY), Danshenfen injection (DSFZ), Fufang Danshen injection (FFDS), Guanxinning injection (GXN), Sodium Tanshinone IIA Sulfonate injection (STS), Xiangdan injection (XD), Shenxiongputaotang injection (SXPTT). The results of NMA showed that, XD injection significantly enhances clinical efficacy; STS is more effective in reducing hs-CRP levels; DSDFSY shows better efficacy in decreasing IL-1 and increasing NO levels; DSCXQ has a greater advantage in reducing IL-6 levels; GXN is more effective in regulating SOD levels; and DH is better at reducing MDA levels.Conclusion: The combined treatment of DSCIs and WM more significant efficacy in patients with CHD compared to WM treatment alone, including clinical efficacy evaluation, inflammatory markers, and oxidative stress markers. Overall, DSDFSY and DSCXQ show better performance in clinical efficacy evaluation and regulation of inflammatory markers, while DH exhibits a more stable effect in regulating oxidative stress. However, larger sample sizes and high-quality RCTs are still necessary to further compare the various DSCIs.Systematic Review Registration: [PROSPERO], identifier [CRD42024548928].

Objective: This study employs bibliometric analysis to map the evolution, identify emerging trends, and evaluate key research themes in microRNA (miRNA) research related to Acute Coronary Syndromes (ACS). By analyzing global publications, we aim to highlight hotspots and translational directions for advancing miRNA applications in ACS diagnosis and therapy. Materials and Methods: Articles on miRNA and ACS published between 2007 and 2023 were retrieved from the Web of Science Core Collection. Data from 1,244 eligible studies were analyzed using CiteSpace and VOSviewer to assess contributions by countries, institutions, authors, journals, and keywords. Visualization tools mapped collaboration networks, co-citation patterns, and keyword trends. Results: China contributed 60% of publications, followed by the United States (12.86%). Harbin Medical University was the most productive institution, while Thum Thomas emerged as the leading researcher. Key research areas included miRNA biomarkers for ACS diagnosis, therapeutic targets for ischemia-reperfusion injury, extracellular vesicles in cardiac repair, and mechanistic studies on apoptosis, autophagy, and inflammation. Emerging frontiers encompassed ventricular remodeling post-AMI, oxidative stress, and clinical translation of miRNA-based strategies. Conclusion: This study provides the first comprehensive bibliometric overview of miRNA research in ACS, revealing sustained growth and interdisciplinary potential. Findings underscore China’s dominance in output and the need for enhanced international collaboration to bridge gaps between basic research and clinical applications. Prioritizing extracellular vesicle-mediated therapies, optimizing miRNA delivery systems, and validating biomarkers in multicenter trials are critical for future advancements.

Objective: This study aimed to evaluate the impact of early rhythm control (ERC) on the occurrence of cardiocerebrovascular events in patients diagnosed with atrial fibrillation detected after stroke (AFDAS).Methods: A systematic search was conducted across nine databases from inception to October 15, 2023 to identify clinical trials comparing ERC with usual care interventions in AFDAS patients. The primary outcome assessed was recurrent stroke, with secondary outcomes including all-cause mortality, adverse events related to arrhythmias, and dementia.Results: Analysis of five studies, consisting of two randomized clinical trials (RCTs) involving 490 patients and three cohort studies involving 95,019 patients, revealed a reduced rate of recurrent stroke [odds ratio (OR) = 0.30, 95% confidence interval (CI) 0.11–0.80, P = 0.016 in RCTs; OR = 0.64, 95% CI 0.61–0.68, P < 0.00001 in cohort studies] and all-cause mortality (hazards ratio = 0.94, 95% CI 0.90–0.98, P = 0.005 in cohort studies) in the ERC group compared to the usual care group. In addition, ERC was associated with superior outcomes in terms of dementia.Conclusions: Patients with AFDAS who underwent ERC treatment exhibited a decreased risk of cardiocerebrovascular events compared to those receiving usual care. These results support the potential benefits of implementing an ERC strategy for this specific patient population.Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, Identifier [CRD42023465994].

Introduction: Previous studies on the optimal timing for antihypertensive medication administration have yielded inconsistent results. While earlier meta-analyses indicated that bedtime dosing significantly reduces myocardial infarction (MI) risk, more recent research has presented conflicting evidence. Therefore, we aimed to evaluate the impact of bedtime versus morning dosing of antihypertensive drugs on cardiovascular outcomes. Methods: We conducted a systematic search across PubMed, EMBASE, and Web of Science databases, covering studies published from inception to 16 July 2025, to identify relevant randomized controlled trials. We calculated risk ratios (RRs) for dichotomous outcomes along with the corresponding 95% confidence intervals (CIs). The study protocol was registered in PROSPERO (ID: CRD420251102968). Results: In total, 8 studies involving 64,235 patients were included in our analysis. Compared with morning dosing, bedtime dosing exhibited no significant differences in all-cause mortality (RR: 0.78; 95% CI: 0.59–1.04; P = 0.09), major adverse cardiovascular events (RR: 0.80; 95% CI: 0.61–1.05; P = 0.10) or cardiovascular death (RR: 0.59; 95% CI: 0.34–1.04; P = 0.07). However, bedtime dosing significantly decreased heart failure risk (RR: 0.67; 95% CI: 0.46–0.96; P = 0.03), lowered clinical systolic blood pressure (mean difference: −3.27 mmHg; 95% CI: −4.13 to −2.41; P < 0.00001), and improved non-dipper conversion (RR: 0.61; 95% CI: 0.47–0.77; P < 0.0001). Non-significant trends favoring bedtime dosing were noted for MI and coronary revascularization. Conclusion: For critical outcomes, including MACE, all-cause mortality and cardiovascular death, no statistically significant benefits associated with bedtime dosing were observed. The overall findings are inconsistent, and the observed advantages for endpoints such as heart failure are closely linked to a single research group, necessitating cautious interpretation. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251102968 , identifier CRD420251102968.

Autumn-Winter weather fluctuations, especially higher wind speed and lower temperature, may trigger acute coronary syndrome (ACS). However, evidence on seasonal exposure-response curves and lag structures remains scarce. We analyzed 2445 ACS admissions from a Beijing tertiary hospital (August 2016-July 2021). Daily meteorological data were linked to admission dates. We applied season-specific analyses-including Spearman correlations, multivariable logistic regression, restricted cubic spline (RCS) curves, and lag-response models-to the autumn and winter data. Wind speed showed a linear positive association with ACS risk: autumn odds ratio (OR) 1.32 (95% confidence interval [CI]: 1.05-1.61, P < 0.05) and winter OR 1.41 (95% CI: 1.13-1.87, P < 0.05). Temperature exhibited non-linear inverse relations with thresholds at ≈ 7.5°C in autumn and - 5°C in winter; below these thresholds, the risk decreased significantly per 1 °C rise (Autumn: OR = 0.76, 95% CI: 0.25-0.96, P < 0.05; Winter: OR = 0.74, 95% CI: 0.47-0.99, P < 0.05). Lag analysis revealed the significant effects at lag 2 for wind speed (Winter OR = 1.40, 95% CI: 1.19-1.67, P < 0.05) and at lag 2 for minimum temperature (Winter OR = 0.87, 95% CI: 0.745-0.996, P < 0.05). Associations were absent in spring and summer. Elevated wind speed and extremely low temperatures are significant, lagged drivers of ACS during the cold season in Beijing. Integrating these variables into seasonal early-warning systems could improve prevention for high-risk populations.

Objective: To evaluate the clinical and preclinical effects of Tongxinluo Capsule (TXL) on acute myocardial infarction (AMI) and to summarize reported mechanisms of action, thereby informing clinical decision-making and future research. Methods: A comprehensive computerized search of eight databases and four clinical trial registries was performed from their inception until 1 April 2025. Data extraction, quality assessment and analysis were conducted in strict accordance with predefined protocols. The methodological quality of included studies was evaluated using the RoB-2 and SYRCLE tools. Statistical analyses were carried out using RevMan 5.4 software, employing fixed-effect or random-effects models as appropriate. Results: This review included 54 clinical studies (4,353 patients in trail group; 4,296 patients in control group) and 11 animal studies (95 animals in trail group; 94 animals in control group). Meta-analysis of clinical studies indicated that, compared with control groups, TXL was associated with lower all-cause mortality, cardiovascular mortality, and incidence of myocardial reinfarction (P < 0.05). Compared with control groups, TXL was associated with lower incidence of repeated revascularization, heart failure, angina pectoris, and arrhythmias (P < 0.05). Furthermore, TXL demonstrated greater improvement in cardiac function indicators and vascular endothelial function (P < 0.001), alongside significant reductions in blood lipids levels (TC, TG, HDL-C, LDL-C; P < 0.05) and inflammation markers. TXL was associated with fewer adverse reactions (P = 0.01), primarily gastrointestinal in nature. In animal studies, TXL was correlated with lower myocardial infarction area and the no-reflow area (P < 0.001), higher cardiac function indicators (LVEF and LVFS; P < 0.05) and better vascular endothelial function (P < 0.05) compared to control group. Reported biological mechanisms of TXL include inhibition of apoptosis, suppression of inflammation, protection of cardiomyocytes and endothelial cells, promotion of angiogenesis, and synergistic lipid-lowering and plaque-stabilization effects. Conclusion: This study is the first meta-analysis to integrate both clinical and animal research on TXL for AMI. The finding suggests that TXL may be associated with alterations in left ventricular systolic function and clinical prognosis, potentially mediated through mechanisms such as inhibition of apoptosis, protecting endothelial function, reducing of inflammation, preservation of cardiomyocytes, and promotion of angiogenesis. Limitations of the included studies constrain the strength of these conclusions, and further validation through larger, high-quality randomized controlled trials is warranted.