Bone marrow-derived mononuclear cell therapy for patients with ischemic heart disease and ischemic heart failure

Abstract

Objective: This meta-analysis aimed to assess whether bone marrow-derived mononuclear cells (BMMNCs) therapy may improve cardiac functional parameters in patients with ischemic heart disease (IHD) or ischemic heart failure (IHF).

Methods: Relevant randomized controlled trials (RCTs) were searched from web databases. Weighted mean difference was calculated for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volumes by using a random effects model.

Results: 13 RCTs met inclusion criteria. Compared with controls, BMMNCs therapy improved LVEF by 3.83% (95% confidence interval (CI): 2.10 - 5.56%; p < 0.0001) in patients with ischemic heart conditions. Notably, in patients with IHF, a more severe clinical condition when compared with IHD, BMMNCs therapy appeared more effective in LVEF improvement. While LVEF increased by 5.67% (95% CI: 3.65 - 7.69%; p < 0.00001) in IHF patients, it only increased by 2.19% (95% CI: 0.37 - 4.00%; p = 0.02) in patients with IHD.

Conclusions: BMMNCs therapy is associated with moderate but significant improvement over regular therapy in LVEF in patients with IHD and IHF. This observation, therefore, supports further RCTs conducting safety and efficiency of BMMNCs therapy with longer-term follow-up.