What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis).

September 10, 2025Open Access

Efficacy & safety of stem cell therapy for treatment of acute myocardial infarction: A systematic review & meta-analysis

PAPravesh AggarwalAll India Institute of Medical Sciences Jodhpur RORanu OzaAll India Institute of Medical Sciences Jodhpur HSHitesh SolankiGujarat University

Key Points

No significant changes in all-cause mortality were found in patients receiving stem cell therapy compared to control groups.
The meta-analysis included 48 studies and evaluated key clinical endpoints such as recurrent myocardial infarction and severe adverse events.
Echocardiographic left ventricular ejection fraction improved significantly post-treatment, although MRI results showed little change.
The analysis indicates serious bias risks for several outcomes, raising questions about the reliability of stem cell interventions.

Abstract

Background & Objectives Stem cell based therapeutic treatments have been used as a management strategy for acute myocardial infarction (AMI), a common primary factor causing death globally. We aimed to undertake a meta-analysis of studies including randomised controlled trials (RCTs) examining different stem cell preparations in AMI, as a definitive answer from this therapeutic approach is yet to emerge. Methods Following PROSPERO registration (CRD42024628552), a systematic search was conducted through PubMed database, Embase, Cochrane, and Web of Science. Data was analysed using RevMan 5.4.1. Primary outcomes included all-cause mortality, recurrent myocardial infarction (Re-MI), severe adverse events (SAEs), hospitalisation for heart failure, cancer incidence, and left ventricular ejection fraction (LVEF). A fixed-effect model was used to assess six outcomes: all-cause mortality, Re-MI, SAEs, heart failure hospitalisation, cancer incidence, and stroke. A model based on random effects depending on heterogeneity was used to assess LVEF. Results From 9,516 records, 48 studies were included for analysis based on available endpoints. No notable changes in all-cause mortality were observed between patients receiving stem cell therapy and those in the control group, according to the meta-analysis. Risk Ratio (RR) 0.73, SAEs (RR 0.93), Re-MI (RR 0.67), HF-related hospitalisation (RR 0.79), cancer (RR 0.82), or stroke (RR 0.81). Echocardiographic LVEF improved significantly at study end Mean difference (MD) 2.53% and difference from baseline (MD 3.89%), with high heterogeneity (I 2 - 76%). MRI-assessed LVEF showed no significant change at study end (MD 0.83%) but improved from baseline (MD 1.37%). Heterogeneity was low except for LVEF, with serious bias risk for most outcomes and very serious for Re-MI and SAEs, though their objective nature limits bias Interpretation & conclusions Analysis done found no significant benefit of stem cell-based therapies on clinical endpoints in AMI patients.

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