Key result
Intracoronary bone marrow mononuclear cell therapy significantly reduced infarct size (MD -2.32) compared to control in patients with ST-elevated myocardial infarction.
Why the study?
Does intracoronary bone marrow mononuclear cell therapy improve left ventricular function in patients with STEMI undergoing PCI?
Meta-Analysis (n=1,536)
Does intracoronary bone marrow mononuclear cell therapy improve left ventricular function in patients with STEMI undergoing PCI?
Mean Difference: -2.32 (95% CI -4.03–-0.62)
p-value: p=0.007
In patients with STEMI undergoing PCI, intracoronary BMMNC therapy improves infarct size and myocardial perfusion but does not significantly affect wall motion score index or wall thickening.
Reduces infarct size in STEMI; extends cell therapy evidence but leaves open effects on LV function.
BACKGROUND: Bone marrow mononuclear cell (BMMNC) therapy has been used as an adjunctive treatment in patients with ST-elevated myocardial infarction (STEMI). However, the therapeutic efficacy of this approach remains controversial. The present meta-analysis is aimed to evaluate the impact of cell therapy on left ventricular function after STEMI. METHODS: We searched through PubMed and EMBASE databases till 2017 for all relevant publications using certain search terms. Randomized controlled trials investigating the effect of BMMNC therapy in patients with STEMI who underwent percutaneous coronary intervention were selected. Wall motion score index (WMSI), infarct size, wall thickening, and myocardial perfusion were our endpoints. RESULTS: A total of 24 trials with 1536 patients were included in our study. Overall, as observed in our data, cell therapy reduced infarct size by -2.32 (95% confidence interval [CI] -4.03, -0.62; P = .007; I = 24%) and improved myocardial perfusion by -3.04 (95% CI -3.94, -2.15; P < .001; I = 0%). However, there was no significant difference between treatment group and control group in WMSI or wall thickening. CONCLUSION: Intracoronary BMMNC infusion is safe for patients with STEMI. It is also associated with improvement of infarct size and myocardial perfusion. Further multicenter randomized trials should be conducted to validate the therapeutic efficacy of this treatment.
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Wang et al. (2018) conducted a meta-analysis in ST-elevated myocardial infarction (n=1,536). Bone marrow mononuclear cell therapy vs. Control media or plasma was evaluated on Mean change in infarct size (MD -2.32, 95% CI -4.03 to -0.62, p=0.007). Intracoronary bone marrow mononuclear cell therapy significantly reduced infarct size (MD -2.32) compared to control in patients with ST-elevated myocardial infarction.
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