OBJECTIVES: We aimed to perform a meta-analysis of clinical trials on intracoronary cell therapy after acute myocardial infarction (AMI). BACKGROUND: Intracoronary cell therapy continues to be evaluated in the setting of AMI with variable impact on left ventricular ejection fraction (LVEF). METHODS: We searched the CENTRAL, mRCT, and PubMed databases for controlled trials reporting on intracoronary cell therapy performed in patients with a recent AMI (< or =14 days), revascularized percutaneously, with follow-up of > or =3 months. The primary end point was change in LVEF, and secondary end points were changes in infarct size, cardiac dimensions, and dichotomous clinical outcomes. RESULTS: Ten studies were retrieved (698 patients, median follow-up 6 months), and pooling was performed with random effect. Subjects that received intracoronary cell therapy had a significant improvement in LVEF (3.0% increase [95% confidence interval (CI) 1.9 to 4.1]; p < 0.001), as well as a reduction in infarct size (-5.6% [95% CI -8.7 to -2.5]; p < 0.001) and end-systolic volume (-7.4 ml [95% CI -12.2 to -2.7]; p = 0.002), and a trend toward reduced end-diastolic volume (-4.6 ml [95% CI -10.4 to 1.1]; p = 0.11). Intracoronary cell therapy was also associated with a nominally significant reduction in recurrent AMI (p = 0.04) and with trends toward reduced death, rehospitalization for heart failure, and repeat revascularization. Meta-regression suggested the existence of a dose-response association between injected cell volume and LVEF change (p = 0.066). CONCLUSIONS: Intracoronary cell therapy following percutaneous coronary intervention for AMI appears to provide statistically and clinically relevant benefits on cardiac function and remodeling. These data confirm the beneficial impact of this novel therapy and support further multicenter randomized trials targeted to address the impact of intracoronary cell therapy on overall and event-free long-term survival.
OBJECTIVES: We aimed to perform a meta-analysis of clinical trials on intracoronary cell therapy after acute myocardial infarction (AMI). BACKGROUND: Intracoronary cell therapy continues to be evaluated in the setting of AMI with variable impact on left ventricular ejection fraction (LVEF). METHODS: We searched the CENTRAL, mRCT, and PubMed databases for controlled trials reporting on intracoronary cell therapy performed in patients with a recent AMI (< or =14 days), revascularized percutaneously, with follow-up of > or =3 months. The primary end point was change in LVEF, and secondary end points were changes in infarct size, cardiac dimensions, and dichotomous clinical outcomes. RESULTS: Ten studies were retrieved (698 patients, median follow-up 6 months), and pooling was performed with random effect. Subjects that received intracoronary cell therapy had a significant improvement in LVEF (3.0% increase [95% confidence interval (CI) 1.9 to 4.1]; p < 0.001), as well as a reduction in infarct size (-5.6% [95% CI -8.7 to -2.5]; p < 0.001) and end-systolic volume (-7.4 ml [95% CI -12.2 to -2.7]; p = 0.002), and a trend toward reduced end-diastolic volume (-4.6 ml [95% CI -10.4 to 1.1]; p = 0.11). Intracoronary cell therapy was also associated with a nominally significant reduction in recurrent AMI (p = 0.04) and with trends toward reduced death, rehospitalization for heart failure, and repeat revascularization. Meta-regression suggested the existence of a dose-response association between injected cell volume and LVEF change (p = 0.066). CONCLUSIONS: Intracoronary cell therapy following percutaneous coronary intervention for AMI appears to provide statistically and clinically relevant benefits on cardiac function and remodeling. These data confirm the beneficial impact of this novel therapy and support further multicenter randomized trials targeted to address the impact of intracoronary cell therapy on overall and event-free long-term survival.
Authors: David M Leistner; Ulrich Fischer-Rasokat; Jörg Honold; Florian H Seeger; Volker Schächinger; Ralf Lehmann; Hans Martin; Iris Burck; Carmen Urbich; Stefanie Dimmeler; Andreas M Zeiher; Birgit Assmus Journal: Clin Res Cardiol Date: 2011-06-03 Impact factor: 5.460
Authors: James D Richardson; Adam J Nelson; Andrew C W Zannettino; Stan Gronthos; Stephen G Worthley; Peter J Psaltis Journal: Stem Cell Rev Rep Date: 2013-06 Impact factor: 5.739
Authors: Ma Eugenia Vázquez-Alvarez; Ricardo Sanz-Ruiz; Enrique Gutiérrez; Adolfo Villa; Ma Eugenia Fernández; Sandra Vázquez; Ma José Lorenzo; Lucía Fernández; Isaac Pascual; Pedro L Sánchez; Francisco Fernández-Avilés Journal: J Cardiovasc Transl Res Date: 2009-12-10 Impact factor: 4.132
Authors: Ramazan Gökmen Turan; Ilkay Bozdag-Turan; Jasmin Ortak; Ibrahim Akin; Stephan Kische; Henrik Schneider; Cem Hakan Turan; Tim Christopher Rehders; Mathias Rauchhaus; Tilo Kleinfeldt; Ester Adolph; Micheal Brehm; Sedat Yokus; Stephan Steiner; Kurtulus Sahin; Christoph A Nienaber; Hüseyin Ince Journal: Stem Cells Dev Date: 2010-12-29 Impact factor: 3.272
Authors: Hirotsugu Hamamoto; Joseph H Gorman; Liam P Ryan; Robin Hinmon; Timothy P Martens; Michael D Schuster; Theodore Plappert; Matti Kiupel; Martin G St John-Sutton; Silviu Itescu; Robert C Gorman Journal: Ann Thorac Surg Date: 2009-03 Impact factor: 4.330