Growth factor for therapeutic angiogenesis in ischemic heart disease: A meta-analysis of randomized controlled trials

Area of Science:

• Cardiology
• Regenerative Medicine
• Clinical Trials

Background:

• Ischemic heart disease (IHD) remains a leading cause of mortality and morbidity worldwide.
• Therapeutic angiogenesis using growth factors (GFs) has been explored as a treatment strategy to improve myocardial perfusion.
• The efficacy and safety of GF therapy in IHD patients require systematic evaluation.

Purpose of the Study:

• To systematically evaluate the effects of growth factor (GF) therapy for therapeutic angiogenesis on outcomes in patients with ischemic heart disease (IHD).
• To pool data from randomized controlled trials (RCTs) to assess the impact of GF therapy on left ventricular ejection fraction (LVEF), angina class, mortality, and cardiovascular events.

Main Methods:

• A systematic review and meta-analysis of RCTs were conducted using data from PubMed, EMBASE, and CENTRAL databases up to October 2022.
• Risk of bias was assessed using the Cochrane tool.
• Meta-analysis, meta-regression, and publication bias analyses were performed to evaluate GF therapy's effects on LVEF, Canadian Cardiovascular Society (CCS) angina class, all-cause mortality, major adverse cardiovascular events (MACE), and revascularization.

Main Results:

• Twenty-nine studies with 2899 IHD patients were included in the meta-analysis.
• GF therapy did not significantly reduce all-cause mortality (RR: 0.82), MACE (RR: 0.83), or revascularization rates (RR: 1.27) compared to control.
• GF therapy showed a significant benefit in increasing left ventricular ejection fraction (LVEF) during short-term follow-up (<1 year).

Conclusions:

• Growth factor therapy for therapeutic angiogenesis demonstrates a short-term benefit in improving LVEF in IHD patients.
• The current evidence does not support the efficacy of GF therapy in reducing long-term outcomes such as all-cause mortality, MACE, or the need for revascularization.