Open AccessIntracoronary infusion of autologous bone marrow cells and left ventricular function after acute myocardial infarction: a meta‐analysis
Author(s) -
Hristov M.,
Heussen Nicole,
Schober A.,
Weber C.
Publication year - 2006
Publication title -
journal of cellular and molecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.44
H-Index - 130
eISSN - 1582-4934
pISSN - 1582-1838
DOI - 10.1111/j.1582-4934.2006.tb00432.x
Subject(s) - medicine , ejection fraction , myocardial infarction , randomized controlled trial , cardiology , placebo , clinical trial , bone marrow , transplantation , surgery , heart failure , pathology , alternative medicine
Recent clinical studies have demonstrated that intracoronary infusion of autologous bone marrow cells (BMC) in conjunction with standard treatment may improve left ventricular function after an acute myocardial infarction (AMI). However, the results of these studies remain controversial, as the studies were relatively small in size and partially differed in design. We reviewed primary controlled randomized clinical studies comparing intracoronary transfer of autologous non‐mobilized BMC combined with standard therapy versus standard therapy alone in patients with AMI. We identified five randomized controlled clinical trials, three of which were also placebo‐ and bone marrow aspiration‐controlled. Non‐mobilized BMC were infused into the revascularized coronary target artery 6.6 ± 6.1 days after AMI. The mean follow‐up period of 5.2 ± 1.1 months was completed by 482 patients, 241 of which received infusion of BMC. The effect of BMC on left ventricular ejection fraction (LVEF) as a major functional parameter was evaluated. Analyzing the overall effect on the change in LVEF between baseline and follow‐up value revealed a significant improvement in the BMCtreated group as compared to the control group (P = 0.04). Thus, considering the increase in LVEF during follow‐up, transplantation of BMC may be a safe and beneficial procedure to support treatment of AMI. However, the functional improvement observed with this form of therapy was altogether relatively moderate and the studies were heterogeneous in design. Hence, further efforts aiming at large‐scale, double‐blind, randomized and placebo‐controlled multi‐center trials in conjunction with better definition of patients, which benefit from BMC infusion, appear to be warranted.