Effectiveness and safety of selected bone marrow stem cells on left ventricular function in patients with acute myocardial infarction: A meta-analysis of randomized controlled trials

- It is the first time to carry out a meta-analysis based on selected bone marrow stem cells (BMSCs) on cardiac repair in patients with acute myocardial infarction (AMI).
- The results of our study showed it was feasible for patients with AMI to receive selected BMSCs in terms of improving left ventricular function based on measurement of LVEF.
- In a subgroup analysis, only BMMSC transplantation specifically resulted in significant improvement in LVEF, whereas there was only a trend toward increased LVEF when the cell type was CD34 + combined with CD133 +, indicating that these cellular subpopulations have different functions in cardiac repair.
- In a subgroup analysis, the results showed that the efficacy of selected BMSCs on LVEF improvement had a does dependent relationship.
- The incidence of MACEs was lower in selected BMSC-treated patients compared with control subjects, with a trend towards reduced incidences of heart failure and arrhythmia, clearly indicating that selected BMSC treatment is safe for patients with AMI.

BackgroundConcerns regarding the use of selected bone marrow stem cells (BMSCs) in the field of cardiac repair after acute ischemic events have been raised. The current meta-analysis aimed to assess the efficacy and safety of selected BMSC transplantation in patients with acute myocardial infarction (AMI) based on published randomized controlled trials (RCTs).MethodsA systematic literature search of PubMed, Ovid LWW, BIOSIS Previews, and the Cochrane library from 1990 to 2014 was conducted. Results from RCTs involving subjects with AMI receiving selected BMSC therapy and followed up for at least 6 months were pooled.ResultsEight trials with a total of 262 participants were included. Data were analyzed using a random effects model. Overall, selected BMSC therapy improved left ventricular ejection fraction (LVEF) by 3.17% (95% confidence interval [CI] 0.57-5.76, P = 0.02), compared with the controls. There were trends toward reduced left ventricular end-systolic volume (LVESV) and fewer major adverse cardiac events (MACEs). Subgroup analysis revealed a significant difference in LVEF in favor of selected BMSC therapy with bone marrow mesenchymal stem cells (BMMSCs) as the cell type.ConclusionsTransplantation of selected BMSCs for patients with AMI is safe and induces a significant increase in LVEF with a limited impact on left ventricular remodeling.