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. 2019 Apr;17(4):2985-2994.
doi: 10.3892/etm.2019.7283. Epub 2019 Feb 15.

Autologous bone marrow stem cell therapy for patients undergoing coronary artery bypass grafting: A meta-analysis of 14 randomized controlled trials

Shanlian Wu  1   2   3   4 , Liang Yao  3 , Peijing Yan  3 , Qiangwei Bao  1   2 , Xin Dong  5 , Xingguang Liu  6 , Yan Zhu  7 , Xin Su  7   8 , Aqian Wang  7   8 , Yichao Duan  7 , Kehu Yang  3   4 , Min Zhang  2 , Yunshan Cao  7
Affiliations

Autologous bone marrow stem cell therapy for patients undergoing coronary artery bypass grafting: A meta-analysis of 14 randomized controlled trials

Shanlian Wu et al. Exp Ther Med. 2019 Apr.

Abstract

Autologous bone marrow stem cell (BMSC) therapy is a novel option for regenerative therapy in patients with ischemic heart disease. The aim of the present meta-analysis was to evaluate the effectiveness of BMSCs combined with coronary artery bypass grafting (CABG). The PubMed, Cochrane Library, EMBASE and Web of Science databases were searched from inception to November 22, 2017 for randomized controlled trials on BMSC therapy combined with CABG. Finally, 14 trials with a total of 596 participants were included. Data were analyzed using a random-effects model. Compared with the control group, the BMSC therapy group exhibited an improvement in the left ventricular (LV) ejection fraction from baseline to follow-up [mean difference (MD)=4.36%; 95% confidence interval (CI): 1.90-6.81%; P<0.01]. Analysis of the pooled results revealed non-significant differences in the LV end-diastolic volume (MD=-6.27 ml; 95% CI: -22.34 to 9.80 ml; P=0.44), LV end-diastolic volume index (MD=-15.11 ml/m2; 95% CI: -31.53 to 1.30 ml/m2; P=0.07), LV end-systolic volume (MD=-11.52 ml; 95% CI: -26.97 to 3.93 ml; P=0.14) and LV end-systolic volume index (MD=-16.56 ml/m2; 95% CI: -37.75 to 4.63 ml/m2; P=0.13) between the BMSC and CABG alone groups. Therefore, autologous BMSC therapy for patients undergoing CABG appears to be associated with an improvement in LV function compared with CABG alone.

Keywords: bone marrow; coronary artery bypass; meta-analysis; randomized controlled trial; stem cell.

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Figures

Figure 1.
Figure 1.
Flow diagram of included studies. RCT, randomized controlled trial; CABG, coronary artery bypass grafting; LV, left ventricle.
Figure 2.
Figure 2.
Risk of bias graph. The authors' judgement regarding each risk of bias item is presented as percentages across all included studies.
Figure 3.
Figure 3.
Risk of bias summary: Authors' judgement regarding each risk of bias item for each of the studies included.
Figure 4.
Figure 4.
Forest plot of the difference in the change from baseline in the left ventricular ejection fraction between the treatment and control groups. Grey boxes represent the weight of the study; diamonds indicate the combined results of the effect size of each study; the data-points represent the mean difference value; horizontal lines represent the 95% CI; CI, confidence interval; MD, mean difference; SD, standard deviation; BMSC, bone marrow stem cell.
Figure 5.
Figure 5.
Forest plot of the difference in the change from baseline in left ventricular end-diastolic volume (ml) between the treatment group and control group. Grey boxes represent the weight of the study; diamonds indicate the combined results of the effect size of each study; the data-points represent the mean difference value; horizontal lines represent the 95% CI; CI, confidence interval; MD, mean difference; SD, standard deviation; BMSC, bone marrow stem cell.
Figure 6.
Figure 6.
Forest plot of the difference in the change from baseline in the left ventricular end-diastolic volume index between the treatment group and the control group (ml/m2). Grey boxes represent the weight of the study; diamonds indicate the combined results of the effect size of each study; the data-points represent the mean difference value; horizontal lines represent the 95% CI; CI, confidence interval; MD, mean difference; SD, standard deviation; BMSC, bone marrow stem cell.
Figure 7.
Figure 7.
Forest plot of the difference in the change from baseline in the left ventricular end-systolic volume (ml) between the treatment group and the control group. Grey boxes represent the weight of the study; diamonds indicate the combined results of the effect size of each study; the data-points represent the mean difference value; horizontal lines represent the 95% CI; CI, confidence interval; MD, mean difference; SD, standard deviation; BMSC, bone marrow stem cell.
Figure 8.
Figure 8.
Forest plot of the difference in the change from baseline in the left ventricular end-systolic volume index between the treatment and control groups (ml/m2). Grey boxes represent the weight of the study; diamonds indicate the combined results of the effect size of each study; the data-points represent the mean difference value; horizontal lines represent the 95% CI; CI, confidence interval; MD, mean difference; SD, standard deviation; BMSC, bone marrow stem cell.
Figure 9.
Figure 9.
Funnel plot of the difference in the change from baseline in the left ventricular ejection fraction in treatment and control groups.
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References

    1. Townsend N, Nichols M, Scarborough P, Rayner M. Cardiovascular disease in Europe-epidemiological update 2015. Eur Heart J. 2015;36:2696–2705. doi: 10.1093/eurheartj/ehv428. - DOI - PubMed
    1. Writing Group Members. Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, Das SR, de Ferranti S, Després JP, et al. Heart Disease and Stroke Statistics-2016 update: A report from the American Heart Association. Circulation. 2016;133:e38–e360. - PubMed
    1. Noiseux N, Mansour S, Weisel R, Stevens LM, Der Sarkissian S, Tsang K, Crean AM, Larose E, Li SH, Wintersperger B, et al. The IMPACT-CABG trial: A multicenter, randomized clinical trial of CD133+ stem cell therapy during coronary artery bypass grafting for ischemic cardiomyopathy. J Thorac Cardiovasc Surg. 2016;152:1582–1588. doi: 10.1016/j.jtcvs.2016.07.067. - DOI - PubMed
    1. Hu S, Liu S, Zheng Z, Yuan X, Li L, Lu M, Shen R, Duan F, Zhang X, Li J, et al. Isolated coronary artery bypass graft combined with bone marrow mononuclear cells delivered through a graft vessel for patients with previous myocardial infarction and chronic heart failure: A single-center, randomized, double-blind, placebo-controlled clinical trial. J Am Coll Cardiol. 2011;57:2409–2415. doi: 10.1016/j.jacc.2011.01.037. - DOI - PubMed
    1. Nasseri BA, Ebell W, Dandel M, Kukucka M, Gebker R, Doltra A, Knosalla C, Choi YH, Hetzer R, Stamm C. Autologous CD133+ bone marrow cells and bypass grafting for regeneration of ischaemic myocardium: The Cardio133 trial. Eur Heart J. 2014;35:1263–1274. doi: 10.1093/eurheartj/ehu007. - DOI - PubMed