Abstract
Introduction
Controversies in stem cell research (Anversa retractions) have led many to question the validity of clinical cell therapy research. There is however consistent data supporting the use of cell therapy for chronic IHD.
Purpose
To update the clinical evidence for the safety and efficacy of autologous adult bone marrow-derived stem/progenitor cells as a treatment for chronic IHD and CHF.
Methods
A full Cochrane review of relevant trials up to 21st November 2018 was performed. Randomised controlled trials comparing autologous adult stem/progenitor cells with no cells in participants with chronic IHD and CHF were deemed eligible. Trials that involved acute myocardial infarction were excluded.
Results
In total 41 randomised controlled trials and 2397 patients are included in the meta-analysis. This updated Cochrane review shows a statistically significant reduction in mortality (RR 0.51; 95% CI, 0.37 to 0.68; p≤0.00001) and MACE (RR 0.66; CI 0.55 to 0.80; p<0.00001) seen with cell therapy. This is associated with a significant improvement in symptoms (exercise tolerance, NYHA, CCS) and ejection fraction.
Conclusions
Cell therapy may be effective for this patient group both for cardiovascular outcomes and symptom control. This conclusion therefore warrants further testing of cell therapy in prospective clinical trials assessing meaningful clinical endpoints.
Stem cell therapy and risk of all-cause
Funding Acknowledgement
Type of funding source: None
Intracoronary autologous stem cell therapy for acute myocardial infarction: a systematic review and meta-analysis of randomised controlled trials