Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2018 Dec;7(12):857-866.
doi: 10.1002/sctm.18-0120. Epub 2018 Sep 26.

Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis

Manoj M Lalu  1   2   3   4 , Sasha Mazzarello  2 , Jennifer Zlepnig  5 , Yuan Yi Ryan Dong  5 , Joshua Montroy  2 , Lauralyn McIntyre  2   6 , P J Devereaux  7 , Duncan J Stewart  3   4 , C David Mazer  8 , Carly C Barron  9 , Daniel I McIsaac  1   2 , Dean A Fergusson  2   5
Affiliations
Meta-Analysis

Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis

Manoj M Lalu et al. Stem Cells Transl Med. 2018 Dec.

Abstract

Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating both acute myocardial infarction (AMI) and ischemic heart failure (IHF). However, the safety profile and efficacy of MSC therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety or efficacy of MSCs for AMI or IHF. Embase, PubMed/Medline, and Cochrane Central Register of Controlled Trials were searched from inception to September 27, 2017. Studies that examined the use of MSCs administered to adults with AMI or IHF were eligible. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by adverse events and the secondary outcome was efficacy which was assessed by mortality and left ventricular ejection fraction (LVEF). A total of 668 citations were reviewed and 23 studies met eligibility criteria. Of these, 11 studies evaluated AMI and 12 studies evaluated IHF. There was no association between MSCs and acute adverse events. There was a significant improvement in overall LVEF in patients who received MSCs (SMD 0.73, 95% CI 0.24-1.21). No significant difference in mortality was noted (Peto OR 0.68, 95% CI 0.38-1.22). Results from our systematic review suggest that MSC therapy for ischemic heart disease appears to be safe. There is a need for a well-designed adequately powered randomized control trial (with rigorous adverse event reporting and evaluations of cardiac function) to further establish a clear risk-benefit profile of MSCs. Stem Cells Translational Medicine 2018;7:857-866.

Keywords: Myocardial infarction; Myocardial ischemia; Stem cells; Systematic review.

PubMed Disclaimer

Figures

Figure 1
Figure 1
The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) flow diagram of the study selection process.
Figure 2
Figure 2
Peto odds ratio (95% CI) and pooled estimates for mortality.
Figure 3
Figure 3
SMD (95% CI) and pooled estimates for left ventricular ejection fraction.
Figure 4
Figure 4
Risk of bias assessment.
See this image and copyright information in PMC

References

    1. Fihn SD, Blankenship JC, Alexander KP et al. ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease. Circulation 2014;2014:2018. - PubMed
    1. dos Santos CC, Murthy S, Hu P et al. Network analysis of transcriptional responses induced by mesenchymal stem cell treatment of experimental sepsis. Am J Pathol 2012;181:1681–1692. - PubMed
    1. Mei SH, Haitsma JJ, Dos Santos CC et al. Mesenchymal stem cells reduce inflammation while enhancing bacterial clearance and improving survival in sepsis. Am J Respir Crit Care Med 2010;182:1047–1057. - PubMed
    1. Williams AR, Hare JM. Mesenchymal stem cells: biology, pathophysiology, translational findings, and therapeutic implications for cardiac disease. Circ Res 2011;109:923–940. - PMC - PubMed
    1. Jackson MV, Morrison TJ, Doherty DF et al. Mitochondrial transfer via tunneling nanotubes is an important mechanism by which mesenchymal stem cells enhance macrophage phagocytosis in the in vitro and in vivo models of ARDS. Stem Cells 2016;34:2210–2223. - PMC - PubMed

Publication types