Stem Cells Improve Left Ventricular Function in Acute Myocardial Infarction

Abstract

BackgroundAnimal studies have suggested dramatic improvement in cardiac function after acute myocardial infarction (AMI) through regeneration of the myocardium or neovascularization by transfer of cells derived from bone marrow (BMC) generated clinical studies. Recently published small sized studies have yielded mixed results, leaving the question unanswered.HypothesisWe analyzed data from these studies in a meta‐analysis to investigate if intracoronary stem cell therapy was effective in improving cardiac function.MethodsA total of 7 randomized controlled trials meeting the inclusion criteria were identified by a systematic literature search. Primary endpoint was change in global left ventricular ejection fraction (LVEF) baseline to follow‐up (ranging between 3 to 6 months). The meta‐analysis consisted of 516 patients (BMC group, 256; control group, 260). A 2‐sided α error of less than .05 was considered to be statistically significant (P<.05).ResultsThere were no significant differences in patient characteristics between the BMC treatment and control groups at baseline. Compared to the control group, patients in the BMC treatment group had significantly greater increase in LVEF from baseline to follow‐up (mean difference: 6.108%; SE: 1.753%; 95% confidence interval [CI]: 2.672%− 9.543%; P<.001).ConclusionsThe present meta‐analysis suggests that intracoronary bone marrow stem cell infusion may be effective in improving left ventricular systolic function in patients after acute myocardial infarction. Copyright © 2009 Wiley Periodicals, Inc.

Stem cells as therapy for cardiac disease — a review

“…Moreover, cells being cultured in vitro and administered in several doses at different times turned out to be indispensable [162]. A meta-analysis by Singh et al [163] suggested that intracoronary infusion of bone marrow stem cells is effective in patients after acute myocardial infarction. But larger randomized trials are needed to validate these results.…”

Still Searching for a New Therapeutic Strategy for Acute Myocardial Infarction

“…A recent meta-analysis that consisted of 516 patients (bone marrow mononuclear cell (BMMC) group, 256 patients; control group, 260 patients) suggested that intracoronary infusion of BMMC might be effective in improving left ventricular (LV) function in patients with AMI, but uncertainty persists regarding the mechanism of restoration of cardiac function. 2 Recent experimental findings indicated that transferred cells exert paracrine effects rather than directly differentiating into cardiomyocytes or endothelial cells in the infarcted region. Pharmacological mobilization of BMMC with granulocyte-colony stimulating factor seems an attractive alternative to intracoronary infusion of BMMC.…”

Stem Cell Tracking in Human Trials: A Meta-Regression

“…Cell therapies can facilitate endogenous repair, e.g. of infarcted tissue [1][2][3][4]; bypass cell dysfunction [5,6] or modulate immune responses that can inhibit tumor growth [7]. Stem cells, in particular, have advantages of being autologously derived (thus avoiding immune reactions); self-replicating; pluripotent, and supportive towards surrounding tissue [8].…”