Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments

BackgroundHydroxysafflor yellow A (HSYA) possesses a variety of pharmacological activities which has been demonstrated to be effective against ischemic heart disease (IHD). This study aimed to comprehensively examine the efficacy and summarize the potential mechanisms of HSYA against IHD in animal m...

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Main Authors: Tianshi Mao, Kaixin Jiang, Yanting Pang, Yi Pan, Wenhao Jia, Qun Gao, Qian Lin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1510657/full
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author Tianshi Mao
Kaixin Jiang
Yanting Pang
Yi Pan
Wenhao Jia
Qun Gao
Qian Lin
Qian Lin
author_facet Tianshi Mao
Kaixin Jiang
Yanting Pang
Yi Pan
Wenhao Jia
Qun Gao
Qian Lin
Qian Lin
author_sort Tianshi Mao
collection DOAJ
description BackgroundHydroxysafflor yellow A (HSYA) possesses a variety of pharmacological activities which has been demonstrated to be effective against ischemic heart disease (IHD). This study aimed to comprehensively examine the efficacy and summarize the potential mechanisms of HSYA against IHD in animal models.MethodsWe conducted electronic searches for preclinical studies on PubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang, and Chinese VIP databases from inception to 31 January 2024. The CAMARADES checklist was chosen to assess the quality of evidence. STATA 14.0 software was utilized to analyze the data. The underlying mechanisms were categorized and summarized.ResultsTwenty-eight studies involving 686 rodents were included and the mean score of methodology quality was 5.04 (range from 4 to 7). Meta-analysis observed that HSYA could decrease myocardial infarction size (SMD: −2.82, 95%CI: −3.56 to −2.08, p < 0.001) and reduce the levels of biomarkers of myocardial injury including cTnI (SMD: −3.82, 95%CI: −5.20 to −2.44, p < 0.001) and CK-MB (SMD: −2.74, 95%CI: −3.58 to −1.91, p < 0.001). HSYA displayed an improvement in cardiac function indicators including LVEF, LVSP, +dp/dt max and -dp/dt max. Furthermore, HSYA was able to reduce the levels of MDA, TNF-α and IL-6, while increasing SOD and NO levels. Mechanistically, the protective effect of HSYA in alleviating myocardial injury after ischemia may be associated with NLRP3 inflammasome, Bcl-2, Bax, caspase-3, eNOS proteins, and TLR/NF-κB, Nrf2/HO-1, JAK/STAT, PI3K/Akt, AMPK/mTOR, VEGFA pathways.ConclusionThis study demonstrates that HSYA exerts cardioprotective effects in decreasing infarct size, reducing myocardial enzymes and improving cardiac function, which may be mediated by anti-inflammatory, antioxidant, anti-apoptotic, regulation of autophagy, improvement of microcirculation and promotion of angiogenesis. However, the absence of safety assessment, lack of animal models of co-morbidities, and inconsistency between timing of administration and clinical practice are limitations of preclinical studies.Systematic Review Registrationclinicaltrials.gov, Identifier, CRD42023460790.
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spelling doaj-art-83f674279fe04f05a95bf6ee14bbff682025-08-20T03:06:13ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-04-011610.3389/fphar.2025.15106571510657Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experimentsTianshi Mao0Kaixin Jiang1Yanting Pang2Yi Pan3Wenhao Jia4Qun Gao5Qian Lin6Qian Lin7Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Cardiology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, ChinaDongfang Hospital, Beijing University of Chinese Medicine, Beijing, ChinaBackgroundHydroxysafflor yellow A (HSYA) possesses a variety of pharmacological activities which has been demonstrated to be effective against ischemic heart disease (IHD). This study aimed to comprehensively examine the efficacy and summarize the potential mechanisms of HSYA against IHD in animal models.MethodsWe conducted electronic searches for preclinical studies on PubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, Wanfang, and Chinese VIP databases from inception to 31 January 2024. The CAMARADES checklist was chosen to assess the quality of evidence. STATA 14.0 software was utilized to analyze the data. The underlying mechanisms were categorized and summarized.ResultsTwenty-eight studies involving 686 rodents were included and the mean score of methodology quality was 5.04 (range from 4 to 7). Meta-analysis observed that HSYA could decrease myocardial infarction size (SMD: −2.82, 95%CI: −3.56 to −2.08, p < 0.001) and reduce the levels of biomarkers of myocardial injury including cTnI (SMD: −3.82, 95%CI: −5.20 to −2.44, p < 0.001) and CK-MB (SMD: −2.74, 95%CI: −3.58 to −1.91, p < 0.001). HSYA displayed an improvement in cardiac function indicators including LVEF, LVSP, +dp/dt max and -dp/dt max. Furthermore, HSYA was able to reduce the levels of MDA, TNF-α and IL-6, while increasing SOD and NO levels. Mechanistically, the protective effect of HSYA in alleviating myocardial injury after ischemia may be associated with NLRP3 inflammasome, Bcl-2, Bax, caspase-3, eNOS proteins, and TLR/NF-κB, Nrf2/HO-1, JAK/STAT, PI3K/Akt, AMPK/mTOR, VEGFA pathways.ConclusionThis study demonstrates that HSYA exerts cardioprotective effects in decreasing infarct size, reducing myocardial enzymes and improving cardiac function, which may be mediated by anti-inflammatory, antioxidant, anti-apoptotic, regulation of autophagy, improvement of microcirculation and promotion of angiogenesis. However, the absence of safety assessment, lack of animal models of co-morbidities, and inconsistency between timing of administration and clinical practice are limitations of preclinical studies.Systematic Review Registrationclinicaltrials.gov, Identifier, CRD42023460790.https://www.frontiersin.org/articles/10.3389/fphar.2025.1510657/fullhydroxysafflor yellow Amyocardial ischemiamyocardial infarctionmyocardial ischemia/reperfusion injurymeta-analysis
spellingShingle Tianshi Mao
Kaixin Jiang
Yanting Pang
Yi Pan
Wenhao Jia
Qun Gao
Qian Lin
Qian Lin
Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
Frontiers in Pharmacology
hydroxysafflor yellow A
myocardial ischemia
myocardial infarction
myocardial ischemia/reperfusion injury
meta-analysis
title Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
title_full Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
title_fullStr Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
title_full_unstemmed Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
title_short Hydroxysafflor yellow A for ischemic heart diseases: a systematic review and meta-analysis of animal experiments
title_sort hydroxysafflor yellow a for ischemic heart diseases a systematic review and meta analysis of animal experiments
topic hydroxysafflor yellow A
myocardial ischemia
myocardial infarction
myocardial ischemia/reperfusion injury
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1510657/full
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