Systematic review on safety of intracoronary autologous bone marrow stem cells transfer in patients with acute myocardial infarction
10.3321/j.issn:0253-3758.2008.08.003
- VernacularTitle:经冠状动脉自体骨髓干细胞移植治疗急性心肌梗死安全性的系统评价
- Author:
Shu-Ning ZHANG
1
;
Ai-Jun SUN
;
Jun-Bo GE
;
Kang YAO
;
Zhe-Yong HUANG
;
Ke-Qiang WANG
;
Yun-Zeng ZOU
Author Information
1. 复旦大学附属中山医院
- Keywords:
Myocardial infarction;
Stem cells;
Transplantation
- From:
Chinese Journal of Cardiology
2008;36(8):679-684
- CountryChina
- Language:Chinese
-
Abstract:
Objective To estimate the safety of intracoronary autologous bone marrow stem cells (BMSC) transfer in patients with acute myocardial infarction. Methods A systematic literature search of PubMed, MEDLINE, Cochrane EBM, BIOSIS, EMBASE and Chinese Journal Full-text Database between January 1990 and May 2007, was performed. Inclusion criteria required that patients received intracoronary BMSC transfer after coronary reperfusion therapy for primary acute myocardial infarction; study design involved patient randomization and matching placebo group as well as detailed safety data with more than 3 months follow-up reults. Results A total of 5 trials with 620 patients were available for analysis. The pooled statistics showed similar results between BMSC and placebo groups in terms of occurrence of the individual clinical adverse events and the combined endpoint death, recurrence of myocardial infarction,or revascularization procedures. The combined endpoint death, recurrence of myocardial infarction, revascularization procedures, or rehospitalization for heart failure was significantly reduced in the BMSC group compared with the control group at more than one year follow-up ( OR = 0. 45, 95% CI 0. 28 - 0. 74, P = 0. 002). Likewise, the occurrence of revascularization and the combined endpoint death, recurrence of myocardial infarction, or revascularization procedures were significantly reduced when BMSC transplantation was performed between 4 and 7 days after primary percutaneous coronary intervention (PCI) ( OR = 0. 60, 95%CI0.37-0.97, P=0.04; OR=0.58, 95%CI0.37 -0.91, P=0. 02, respectively). In contrast,there was a significant increase in the combined endpoint revascularization and recurrence of myocardial infarction when BMSC transplantation was performed within 24 hours after PCI (OR = 2. 56, 95% CI 1.03 - 6. 34, P = 0. 04). Conclusions Post PCI intracoronary autologous BMSC transplantation in patients with acute myocardial infarction is safe, especially in patients received BMSC transplantation between 4 and 7days after primary PCI than patients received BMSC transplantation within 24 hours post PCI.
