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Autologous bone marrow stem cell transplantation for patients undergoing coronary artery bypass grafting: a
Juelin Song1, Kang He1, Jianglong Hou2
1Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Insights
Bone marrow stem cell (BMSC) transplantation combined with coronary artery bypass grafting (CABG) improves left ventricular ejection fraction compared to CABG alone. Further research is needed to understand patient response variability to this therapy.
Area of Science:
- Cardiology
- Regenerative Medicine
- Clinical Trials
Background:
- Coronary artery bypass grafting (CABG) and bone marrow stem cell (BMSC) transplantation are established procedures.
- The combined efficacy of CABG with BMSC transplantation versus CABG alone is debated.
Purpose of the Study:
- To evaluate the effectiveness of BMSC transplantation combined with CABG compared to CABG alone.
- To conduct an updated meta-analysis of randomized controlled trials.
Main Methods:
- A random-effects meta-analysis was performed.
- Searched PubMed, Embase, and Cochrane databases for relevant studies.
- Included 22 studies comparing isolated CABG with CABG plus BMSC transplantation.
Main Results:
- 22 studies with 820 patients were analyzed (432 in BMSC group, 388 in CABG group).
- The BMSC transplantation group showed a significant improvement in left ventricular (LV) ejection fraction (mean difference = 3.87%).
- Statistical significance was P < 0.001 with a 95% confidence interval of 1.93-5.80%.
Conclusions:
- Autologous BMSC transplantation with CABG appears to enhance LV function compared to CABG alone.
- Significant heterogeneity in study data indicates varied patient responses to therapy.
- Further research is required to elucidate the reasons behind these individual response differences.
Background:
Although the safety and feasibility of coronary artery bypass grafting (CABG) and bone marrow stem cell (BMSC) transplantation have been established, the effectiveness of this approach compared with CABG alone remains controversial. The aim of this updated meta-analysis of randomized controlled trials was to evaluate the efficacy of this procedure.
Methods:
A random-effects meta-analysis was conducted using studies sourced from the PubMed, Embase, and Cochrane literature databases to compare patients who received isolated CABG (CABG group) and BMSC transplantation with CABG (BMSC group). 22 studies were included.
Results:
A total of 22 relevant publications with 820 patients were included. 432 patients received BMSC transplantation with CABG and 388 patients received isolated CABG. Compared with the CABG group, the BMSC transplantation group exhibited an improvement in the left ventricular (LV) ejection fraction (mean difference (MD) = 3.87%; 95% confidence interval (CI): 1.93-5.80%; P < 0.001).
Conclusion:
The present evidence suggests that autologous BMSC transplantation for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone. However, heterogeneity in the data suggests that patients respond differently to this therapy. Further research is needed to understand these differences.
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