Discrepancy between short-term and long-term effects of bone marrow-derived cell therapy in acute myocardial infarction: a systematic review and meta-analysis

Background: Several lines of evidence support the clinical use of trimetazidine as an adjunctive therapy in cardioischemic patients. Therefore, we assessed here the efficacy and safety of adjunctive trimetazidine therapy in acute myocardial infarction (MI) patients by a systematic review and meta-analysis of the current literature. Methods: PubMed, the Cochrane Library, and the China National Knowledge Infrastructure databases were searched for clinical studies comparing adjunctive trimetazidine therapy against placebo in adult acute MI patients. Several clinical outcomes [early/short-term all-cause mortality, long-term all-cause mortality, total major adverse cardiac events (MACE), recurrent nonfatal MI, in-hospital adverse events, target vessel revascularization (TVR), and coronary artery bypass graft (CABG)] were analyzed by the intention-to-treat principle. Odds ratios (OR) and their 95% confidence intervals (CI) were derived from the number of outcome events in each study arm to estimate the association between adjuvant trimetazidine administration and the various clinical outcomes. A random-effects model was applied for all meta-analyses. Results: We found that adjunctive trimetazidine therapy showed a significant effect upon total MACE (OR = 0.33, 95% CI = 0.15-0.74; p = 0.007) but showed no significant effect upon early/short-term all-cause mortality, long-term all-cause mortality, recurrent nonfatal MI, in-hospital adverse events, TVR, or CABG (p > 0.05). Conclusions: This is the first meta-analysis to report that adjunctive trimetazidine therapy has a beneficial effect upon total MACE in acute MI patients. Clinical investigators should consider further trials on adjunctive trimetazidine therapy in order to better define its risks and benefits in acute MI patients.

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Age, gender and diabetic status are associated with effects of bone marrow cell therapy on recovery of left ventricular function after acute myocardial infarction: A systematic review and meta-analysis

Ageing Research Reviews ◽

10.1016/j.arr.2010.05.001 ◽

2010 ◽

Vol 9 (4) ◽

pp. 418-423 ◽

Cited By ~ 23

Author(s):

Yongyi Bai ◽

Tao Sun ◽

Ping Ye

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Bone Marrow ◽

Cell Therapy ◽

Marrow Cell ◽

Meta Analysis ◽

Left Ventricular ◽

Diabetic Status ◽

Bone Marrow Cell Therapy

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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

Advances in Clinical and Experimental Medicine ◽

10.17219/acem/66385 ◽

2018 ◽

Vol 27 (1) ◽

pp. 21-37 ◽

Cited By ~ 1

Author(s):

Mei Yang ◽

Quanfu Xu ◽

Bo Liu ◽

Xiu Chen ◽

Yigang Li

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Bone Marrow ◽

Stem Cell ◽

Cell Therapy ◽

Meta Analysis ◽

Bone Marrow Stem Cell ◽

Cardiac Outcomes ◽

Marrow Stem Cell

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Association Between Out-of-Hour Admission and Short- and Long-Term Mortality in Acute Myocardial Infarction: A Systematic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.752675 ◽

2021 ◽

Vol 8 ◽

Author(s):

Yue-Yan Yu ◽

Bo-Wen Zhao ◽

Lan Ma ◽

Xiao-Ce Dai

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Publication Bias ◽

Meta Analysis ◽

Short Term ◽

Short Term Mortality ◽

Short And Long Term ◽

Long Term Mortality

Objectives: Out-of-hour admission (on weekends, holidays, and weekday nights) has been associated with higher mortality in patients with acute myocardial infarction (AMI). We conducted a meta-analysis to verify the association between out-of-hour admission and mortality (both short- and long-term) in AMI patients.Design: This Systematic review and meta-analysis of cohort studies.Data Sources: PubMed and EMBASE were searched from inception to 27 May 2021.Eligibility Criteria for Selected Studies: Studies of any design examined the potential association between out-of-hour admission and mortality in AMI.Data Extraction and Synthesis: In total, 2 investigators extracted the data and evaluated the risk of bias. Analysis was conducted using a random-effects model. The results are shown as odds ratios [ORs] with 95% confidence intervals (CIs). I2 value was used to estimate heterogeneity. Grading of Recommendations Assessment, Development, and Evaluation was used to assess the certainty of the evidence.Results: The final analysis included 45 articles and 15,346,544 patients. Short-term mortality (defined as either in-hospital or 30-day mortality) was reported in 42 articles (15,340,220 patients). Out-of-hour admission was associated with higher short-term mortality (OR 1.04; 95%CI 1.02–1.05; I2 = 69.2%) but there was a significant statistical indication for publication bias (modified Macaskill's test P < 0.001). One-year mortality was reported in 10 articles (1,386,837 patients). Out-of-hour admission was also associated with significantly increased long-term mortality (OR 1.03; 95%CI 1.01–1.04; I2 = 66.6%), with no statistical indication of publication bias (p = 0.207). In the exploratory subgroup analysis, the intervention effect for short-term mortality was pronounced among patients in different regions (p = 0.04 for interaction) and socio-economic levels (p = 0.007 for interaction) and long-term mortality was pronounced among patients with different type of AMI (p = 0.0008 for interaction) or on different types of out-to-hour admission (p = 0.006 for interaction).Conclusion: Out-of-hour admission may be associated with an increased risk of both short- and long-term mortality in AMI patients.Trial Registration: PROSPERO (CRD42020182364).

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Effects of mechanical circulatory support devices in patients with acute myocardial infarction undergoing stent implantation: a systematic review and meta-analysis of randomised controlled trials

BMJ Open ◽

10.1136/bmjopen-2020-044072 ◽

2021 ◽

Vol 11 (6) ◽

pp. e044072

Author(s):

Yunmin Shi ◽

Yujie Wang ◽

Xuejing Sun ◽

Yan Tang ◽

Mengqing Jiang ◽

...

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Acute Myocardial Infarction ◽

Clinical Outcomes ◽

Stent Implantation ◽

Mechanical Circulatory Support ◽

Meta Analysis ◽

Circulatory Support ◽

Short Term

ObjectiveThe survival benefit of using mechanical circulatory support (MCS) in patients with acute myocardial infarction (AMI) is still controversial. It is necessary to explore the impact on clinical outcomes of MCS in patients with AMI undergoing stenting.DesignSystematic review and meta-analysis.Data sourcesEmbase, Cochrane Library, Medline, PubMed, Web of Science, ClinicalTrials.gov and Clinicaltrialsregister.eu databases were searched from database inception to February 2021.Eligibility criteriaRandomised clinical trials (RCTs) on MCS use in patients with AMI undergoing stent implantation were included.Data extraction and synthesisData were extracted and summarised independently by two reviewers. Risk ratios (RRs) and 95% CIs were calculated for clinical outcomes according to random-effects model.ResultsTwelve studies of 1497 patients with AMI were included, nine studies including 1382 patients compared MCS with non-MCS, and three studies including 115 patients compared percutaneous ventricular assist devices (pVADs) versus intra-aortic balloon pump (IABP). Compared with non-MCS, MCS was not associated with short-term (within 30 days) (RR=0.90; 95% CI 0.57 to 1.41; I2=46.8%) and long-term (at least 6 months) (RR=0.82; 95% CI 0.57 to 1.17; I2=37.6%) mortality reductions. In the subset of patients without cardiogenic shock (CS) compared with non-MCS, the patients with IABP treatment significantly had decreased long-term mortality (RR=0.49; 95% CI 0.27 to 0.90; I2=0), but without the short-term mortality reductions (RR=0.51; 95% CI 0.22 to 1.19; I2=17.9%). While in the patients with CS, the patients with MCS did not benefit from the short-term (RR=1.09; 95% CI 0.67 to 1.79; I2=46.6%) or long-term (RR=1.00; 95% CI 0.75 to 1.33; I2=22.1%) survival. Moreover, the application of pVADs increased risk of bleeding (RR=1.86; 95% CI 1.15 to 3.00; I2=15.3%) compared with IABP treatment (RR=1.86; 95% CI 1.15 to 3.00; I2=15.3%).ConclusionsIn all patients with AMI undergoing stent implantation, the MCS use does not reduce all-cause mortality. Patients without CS can benefit from MCS regarding long-term survival, while patients with CS seem not.

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EP.WE.14Prognostic significance of metabolic syndrome in patients undergoing carotid artery revascularisation: A systematic review and meta-analysis

British Journal of Surgery ◽

10.1093/bjs/znab308.001 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Shahab Hajibandeh ◽

Shahin Hajibandeh

Keyword(s):

Myocardial Infarction ◽

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Prognostic Significance ◽

Long Term Outcomes ◽

Short Term ◽

All Cause Mortality ◽

Major Adverse Events

Abstract Aims to evaluate prognostic significance of metabolic syndrome (MetS) in patients undergoing carotid artery revascularisation. Methods A systematic review and meta-analysis was performed in compliance with PRISMA standards to evaluate prognostic significance of MetS in patients undergoing carotid endarterectomy or carotid stenting. Short-term (<30 days) postoperative outcomes (all-cause mortality, stroke or transient ischaemic attack (TIA), myocardial infarction, major adverse events) and long-term outcomes (restenosis, all-cause mortality, stroke or TIA, myocardial infarction, major adverse events) were considered as outcomes of interest. Random effects modelling was applied for the analyses. Results Analysis of 3721 patients from five cohort studies showed no difference between the MetS and no MetS groups in terms of the following short-term outcomes: all-cause mortality (OR: 1.67,P=0.32), stroke or TIA (OR: 2.44,P=0.06), myocardial infarction (OR: 1.01,P=0.96), major adverse events (OR: 1.23, P = 0.66). In terms of long-term outcomes, MetS was associated with higher risk of restenosis (OR: 1.75,P=0.02), myocardial infarction (OR: 2.12,P=0.04), and major adverse events (OR: 1.30, P = 0.009) but there was no difference between the two groups in terms of all-cause mortality (OR: 1.11, P = 0.25), and stroke or TIA (OR: 1.24, P = 0.33). The quality and certainty of the available evidence were judged to be moderate. Conclusions The best available evidence suggest that although MetS may not affect the short-term postoperative morbidity and mortality outcomes in patients undergoing carotid revascularisation, it may result in higher risks of restenosis, myocardial infarction and major adverse events in the long-term. Evidence from large prospective cohort studies are required for more robust conclusions.

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