Stem cell treatment for acute myocardial infarction

Area of Science:

• Regenerative Medicine
• Cardiovascular Research
• Stem Cell Therapy

Background:

• Cell transplantation is a potential therapy for repairing vascular and cardiac tissue post-acute myocardial infarction (AMI).
• Numerous randomized controlled trials (RCTs) have investigated this approach globally.

Purpose of the Study:

• To assess the safety and efficacy of autologous adult bone marrow stem cells for treating acute myocardial infarction (AMI).
• Focus on evaluating clinical outcomes and patient recovery.

Main Methods:

• An updated Cochrane review including randomized controlled trials (RCTs) comparing autologous bone marrow cells to no cell treatment in AMI patients.
• Searched multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL, Transfusion Evidence Library) up to March 2015.
• Meta-analyses were performed on short-term and long-term outcomes, with sensitivity and subgroup analyses.

Main Results:

• Forty-one RCTs with 2732 participants were included; cell treatment showed no significant impact on all-cause mortality, cardiovascular mortality, or a composite of mortality, reinfarction, and re-hospitalization.
• No significant effects were observed on morbidity, quality of life, or left ventricular ejection fraction (LVEF) by MRI.
• Minor LVEF improvements by echocardiography or other imaging were not clinically relevant; serious adverse events were rare and unrelated to cell therapy.

Conclusions:

• Current evidence suggests insufficient benefit from cell therapy for AMI patients.
• Existing trials are often small and show no clinically relevant outcome differences.
• Adequately powered trials are necessary to establish the efficacy of cell therapy for AMI.