The beneficial effects of intracoronary autologous bone marrow stem cell transfer as an adjunct to percutaneous coronary intervention in patients with acute myocardial infarction

Abstract

The efficacy of post-percutaneous coronary intervention (PCI) intracoronary injection with bone marrow mesenchymal stem cells (BMSCs) in patients with acute myocardial infarction (AMI) remains controversial. Here, 58 patients with AMI undergoing PCI were randomly divided into two groups: BMSC and control groups. Autologous BSMCs were then generated in vitro from the BMSC patients. After transplantation, left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimensions (LVDd), and infarct size (IS) were evaluated in both groups. LVEF, LVDd, and IS improved after BMSC transplantation but the changes were not significantly different from those in the controls. The number of adverse events and rehospitalization rates after 1 month were significantly higher in the control group than in the BMSC group. BMSC transplantation thus benefits patients by decreasing the number of adverse events and reducing the rehospitalization rate in the early stages following PCI.

Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis

“…Of the 23 included studies, 11 evaluated AMI ( n = 509 patients) and 12 evaluated IHF ( n = 639 patients) (Table ). Of these studies, eight were RCTs that evaluated AMI ( n = 429 patients) and five were RCTs that evaluated IHF ( n = 472 patients) . The number of evaluated patients who received MSCs ranged from 9 to 58 patients for the AMI studies and from 6 to 107 patients for the IHF studies.…”

“…Follow‐up duration ranged from 6 to 60 months. Of the studies evaluating AMI, seven studies specified safety and four studies specified efficacy as their primary outcome. Secondary outcomes assessed included safety or efficacy .…”

Stem Cell Therapy in Heart Diseases – Cell Types, Mechanisms and Improvement Strategies

“…However, the beneficial effects of MSCs on global cardiac function in a clinical setting remain uncertain. Several randomized controlled clinical trials showed a significantly improved LVEF after MSC transplantation [110][111][112], whereas others did not observe differences between SC treated and control groups [74,[113][114][115][116][117]. Furthermore, neither a recent meta-analysis of pre-clinical studies [118] nor comparative clinical studies [119,120] detected significant differences of autologous versus allogeneic MSCs on cardiac function.…”

Methodological exploration of bone marrow stem cell therapy in acute myocardial infarction – how to achieve greater benefit on cardiac outcomes: A systematic review and meta-analysis

“…Total events Heterogeneity: χ 2 = 11.63, df = 11 (p = 0.39); I 2 = 5% Test for overall effect: Z = 0.72 (p = 0.47) Test for subgroup differences: χ 2 = 4.37, df = 1 (p = 0.04); I 2 Table A).…”

“…The sensitivity analysis excluding 1 study at a time confirmed the results concerning all analyses in terms of direction and magnitude of statistical significance. The statistical heterogeneity(I 2 ) for LVEF vanished dramatically from 93% to 27%, indicating low heterogeneity among the majority of the studies included, except for the study by Wang et al 2 Considering LVEF as the primary endpoint for almost all studies, this study was excluded in the following statistical analyses. After the exclusion, the heterogeneity for most cardiac parameters and all clinical outcomes was low.…”