Can acupuncture improve cardiac function in patients after percutaneous coronary intervention? A systematic review and meta-analysis.

BACKGROUND: To systematically evaluate the effects of acupuncture in improving cardiac function and the reported adverse events in patients after percutaneous coronary intervention (PCI) through meta-analysis. METHODS: Electronic databases including PubMed, China National Knowledge Infrastructure, Wanfang Medical, China Biomedical Literature Database, VIP Database, Embase, Ovid Medline, Sinomed Database and the Cochrane Library were searched from inception to May 2026. Two reviewers independently screened the literature according to the inclusion and exclusion criteria and extracted data. The methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1), and meta-analysis was performed with Review Manager 5.3. The evidence was appraised per the GRADE framework. RESULTS: A total of 8 RCTs involving 759 patients were included, with 379 patients in the acupuncture group (247 males and 132 females) and 380 in the control group (conventional treatment or sham acupuncture; 257 males and 123 females). The results of the meta-analysis showed that, revealing that acupuncture was associated with better outcomes than conventional treatment or sham acupuncture in several measures. Specifically, the intervention led to a substantial boost in left ventricular ejection fraction (LVEF) by an average of 4.26 percentage points [95% CI (1.21, 7.31), P = 0.006], while also enhancing functional capacity as evidenced by a 43.88-m improvement in the 6-minute walk distance [95% CI (10.40, 77.36), P = 0.01]. On the biochemical front, acupuncture demonstrated its efficacy by reducing serum creatine kinase-MB (CK-MB) levels [SMD = -1.99, 95% CI (-3.46, -0.52), P = 0.008]. The treatment also showed favorable effects on cardiac remodeling, evidenced by decreased left ventricular end-systolic diameter (LVESD) by 2.56 mm [95% CI (-4.65, -0.46), P = 0.02] and left ventricular end-diastolic diameter (LVEDD) by 1.36 mm [95% CI (-2.34, -0.37), P = 0.007]. Additionally, acupuncture was associated with a lower risk of major adverse cardiovascular events (MACE) by 60% [RR = 0.40, 95% CI (0.24, 0.66), P = 0.0005], positioning it as a promising adjunctive therapy for cardiovascular management. CONCLUSION: Current evidence suggests that acupuncture may improve cardiac function in patients after PCI. However, the available literature is limited in both quantity and methodological quality. More rigorously designed, large-sample, high-quality RCTs are warranted to further validate these findings and provide more robust evidence for evidence-based practice. SYSTEMATIC REVIEW REGISTRATION: identifier CRD420261410954.