Qiang Zhao1, Xiaofeng Ye. 1. Shanghai Jiaotong University, Ruijin Hospital, Department of Cardiac Surgery, Shanghai 200025, PR China. zq11607@rjh.com.cn
Abstract
OBJECTIVE: Whether adult bone marrow (BM)-derived cells (BMCs) transplantation benefits patients with chronic ischemic heart disease (IHD) remains controversial. This systemic and meta-analysis study aimed to assess the potential therapeutic effects of BMCs transplantation with revascularization in chronic IHD. RESEARCH DESIGN AND METHODS: Randomized controlled trials of BMCs in combination with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for chronic IHD were identified by searching Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Web of Science. We conducted a random-effects meta-analysis across eligible studies measuring the same outcomes. RESULTS: Ten randomized controlled trials including 422 participants were reviewed. In the trials with six months of follow-up, BMCs transplantation improved left ventricular (LV) ejection fraction (LVEF) by 4.02% and reduced LV end-systolic and end-diastolic volumes. Subgroup analysis revealed a statistically significant difference in LVEF associated with primary intervention, route of cell delivery, cell type, and baseline LVEF, but not with cell dose or storage duration. CONCLUSIONS: Selected-BMCs transplantation through myocardial injection after surgical revascularization may benefit patients with chronic IHD and severely impaired LV function. Due to the limitation of patient number, RCT with larger sample size and long follow-up are required for future research.
OBJECTIVE: Whether adult bone marrow (BM)-derived cells (BMCs) transplantation benefits patients with chronic ischemic heart disease (IHD) remains controversial. This systemic and meta-analysis study aimed to assess the potential therapeutic effects of BMCs transplantation with revascularization in chronic IHD. RESEARCH DESIGN AND METHODS: Randomized controlled trials of BMCs in combination with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) for chronic IHD were identified by searching Medline, Embase, the Cochrane Controlled Trials Register, the Cochrane Library, and the Web of Science. We conducted a random-effects meta-analysis across eligible studies measuring the same outcomes. RESULTS: Ten randomized controlled trials including 422 participants were reviewed. In the trials with six months of follow-up, BMCs transplantation improved left ventricular (LV) ejection fraction (LVEF) by 4.02% and reduced LV end-systolic and end-diastolic volumes. Subgroup analysis revealed a statistically significant difference in LVEF associated with primary intervention, route of cell delivery, cell type, and baseline LVEF, but not with cell dose or storage duration. CONCLUSIONS: Selected-BMCs transplantation through myocardial injection after surgical revascularization may benefit patients with chronic IHD and severely impaired LV function. Due to the limitation of patient number, RCT with larger sample size and long follow-up are required for future research.
Authors: Vasileios Karantalis; Darcy L DiFede; Gary Gerstenblith; Si Pham; James Symes; Juan Pablo Zambrano; Joel Fishman; Pradip Pattany; Ian McNiece; John Conte; Steven Schulman; Katherine Wu; Ashish Shah; Elayne Breton; Janice Davis-Sproul; Richard Schwarz; Gary Feigenbaum; Muzammil Mushtaq; Viky Y Suncion; Albert C Lardo; Ivan Borrello; Adam Mendizabal; Tomer Z Karas; John Byrnes; Maureen Lowery; Alan W Heldman; Joshua M Hare Journal: Circ Res Date: 2014-02-24 Impact factor: 17.367