Intramyocardial Stem Cell Transplantation during Coronary Artery Bypass Surgery Safely Improves Cardiac Function: Meta-Analysis of 20 Randomized Clinical Trials
- PMID: 37445467
- PMCID: PMC10342819
- DOI: 10.3390/jcm12134430
Intramyocardial Stem Cell Transplantation during Coronary Artery Bypass Surgery Safely Improves Cardiac Function: Meta-Analysis of 20 Randomized Clinical Trials
Abstract
IMSC transplantation during CABG is considered one of the most promising methods to effectively deliver stem cells and has been widely studied in many trials. But the results of outcomes and safety of this modality still vary widely. We conducted this meta-analysis of randomized controlled trials (RCTs) to evaluate not only the outcome but also the safety of this promising method. A meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, and Cochrane databases. Articles were thoroughly evaluated and analyzed. Twenty publications about IMSC during CABG were included. Primary outcomes were measured using LVEF, LVESV, LVESVI, LVESD, LVEDV, LVEDVI, LVEDD, WMSI, and 6-MWT. Safety measures were depicted by total deaths, MACE, CRD, CVA, myocardial infarction, ventricular arrhythmia, and cardiac-related readmission. IMSC transplantation during CABG significantly improved LVEF (MD = 3.89%; 95% CI = 1.31% to 6.46%; p = 0.003) and WMSI (MD = 0.28; 95% CI = 0.01-0.56; p = 0.04). Most of the other outcomes showed favorable results for the IMSC group but were not statistically significant. The safety analysis also showed no significant risk difference for IMSC transplantation compared to CABG alone. IMSC during CABG can safely improve cardiac function and tend to improve cardiac volumes and dimensions. The analysis and application of influencing factors that increase patients' responses to IMSC transplantation are important to achieve long-term improvement.
Keywords: coronary artery bypass; intramyocardial; ischemic heart disease; outcome; safety; stem cell.
Conflict of interest statement
The authors declare no conflict of interest.
Figures



















References
-
- Soetisna T.W., Sukmawan R., Setianto B., Mansyur M., Murni T.W., Listiyaningsih E., Santoso A. Combined Transepicardial and Transseptal Implantation of Autologous CD133+ Bone Marrow Cells during Bypass Grafting Improves Cardiac Function in Patients with Low Ejection Fraction. J. Card. Surg. 2020;35:740–746. doi: 10.1111/jocs.14454. - DOI - PMC - PubMed
-
- He X., Wang Q., Zhao Y., Zhang H., Wang B., Pan J., Li J., Yu H., Wang L., Dai J., et al. Effect of Intramyocardial Grafting Collagen Scaffold With Mesenchymal Stromal Cells in Patients With Chronic Ischemic Heart Disease. JAMA Netw. Open. 2020;3:e2016236. doi: 10.1001/jamanetworkopen.2020.16236. - DOI - PMC - PubMed
-
- Li Z., Lin L., Wu H., Yan L., Wang H., Yang H., Li H. Global, Regional, and National Death, and Disability-Adjusted Life-Years (DALYs) for Cardiovascular Disease in 2017 and Trends and Risk Analysis From 1990 to 2017 Using the Global Burden of Disease Study and Implications for Prevention. Front. Public Health. 2021;9:559751. doi: 10.3389/fpubh.2021.559751. - DOI - PMC - PubMed
Publication types
LinkOut - more resources
Full Text Sources