Direct autologous bone marrow-derived stem cell transplantation for ischemic heart disease: a meta-analysis

Abstract

Objective: Previous evaluation of intracoronary autologous bone marrow-derived stem cell (BMSCs) therapy following ischemic heart disease (IHD) suggested improvement of cardiac functional parameters. We performed a meta-analysis to provide systematic assessment of the safety and efficacy of direct (intramyocardial or endomyocardial) BMSCs transplantation in patients with IHD.Research design and methods: Randomized controlled Trials (RCTs) were identified in the MEDLINE (∼ Oct. 2010), the Cochrane Central Register of Controlled Trials (Central) (∼ Oct. 2010), EMBASE (∼ Oct. 2010), and EBSCO (∼ Oct. 2010), reviews, and reference lists of relevant articles. Weighted mean difference (WMD) was calculated for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV) by using a fixed effects model.Results: Eight RCTs with 307 participants were eligible. Compared with controls, direct BMSCs transplantation improved LVEF (8.4%, 95% CI, 6.49 to 10.31%; p < 0.01), reduced LVESV and LVEDV (–14.85 ml, 95%CI, –27.29 to –2.41 ml, p = 0.02 and –12.79 ml, 95% CI, –24.94 to –0.65 ml, p = 0.04, respectively).Conclusions: This meta-analysis suggests that direct BMSCs transplantation is associated with moderate but significant improvements over regular therapy in cardiac functional parameters in patients with IHD, and supports conducting further RCTs of a higher quality.