The safety and efficacy of bone marrow stem cell transplantation for ischemic heart failure: a Meta-analysis / 中国组织工程研究

ABSTRACT

BACKGROUND: The bone marrow stem cells (BMSCs) transplantation has been used for the treatment of ischemic heart failure in clinic. But the efficacy and safety of BMSCs transplantation remains controversial. OBJECTIVE: To systematically assess the efficacy and safety of BMSCs transplantation on ischemic heart failure through a Meta-analysis. METHODS: PubMed, Cochrane Library (Issue 10, 2016), Embase, CNKI, CBM, VIP, WanFang were search for relevant randomized controlled trials (RCTs). After data extracting and quality assessing, Meta-analysis was performed using RevMan5.3 software. RESULTS AND CONCLUSION: A total of 8 RCTs involving 350 patients, 191 in the BMSCs group and 159 in the conventional therapy group, were included. Meta-analysis results showed that compared with the conventional therapy, BMSCs transplantation could increase the left ventricular ejection fraction[MD=4.68,95% CI(1.79,7.56),P<0.01].But there was no significant difference in decreasing left ventricular end-diastolic volume[MD=-3.86,95% CI(-9.90,2.17),P=0.21]and left ventricular end-systolic volume[MD=-3.20,95% CI(-9.21,2.80), P=0.30].And the incidence of adverse events was not significantly different[RR=0.85,95% CI(0.25,2.89),P=0.79]in the course of the treatment. Overall findings indicate that BMSCs transplantation for ischemic heart failure is safe and able to significantly increase patient's left ventricular ejection fraction. However, BMSCs transplantation by intracoronary injection may have no effect on the left ventricular remodeling in ischemic heart failure patients. Due to the limitations of current studies, high-quality RCTs are needed to further verify our findings.