Safety and efficacy of bone marrow-derived cells therapy on cardiomyopathy: a meta-analysis

Abstract

Background

Controversial results still existed on the clinical utility of bone marrow-derived cells (BMCs) for cardiomyopathy (CMP). This study aims to reveal the true power of this promising approach by synthesizing all the available data on this subject matter.

Methods

Twenty studies including 1418 patients were identified from systematic search. Weighted mean differences for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), 6-min walk distance, and NYHA functional class were estimated with a random-effects model. Major adverse cardiovascular event (MACE), rehospitalization, all-cause mortality, and patients’ quality of life were also calculated.

Results

Compared with the control group, BMC therapy resulted in greater LVEF (3.72%, 95% CI 2.31 to 5.13, P < 0.0001), 6-min walk distance (53.16, 95% CI 25.17 to 81.10, P = 0.0002), NYHA functional class (− 0.48, 95% CI − 0.65 to − 0.31, P < 0.0001), and smaller LVESV (− 16.79, 95% CI − 27.21 to − 6.38, P = 0.002). BMC treatment significantly reduced the mortality rate and improved patients’ quality of life. No significant difference was found between the BMCs and control group in LVEDV, MACE, and rehospitalization rate. However, the outcomes showed a clear trend in favor of the BMC group. Subgroup analysis showed that LVEF improved greater in a subgroup of intracoronary infusion, BMSC, or higher cell dose.

Conclusion

The results of the current meta-analysis suggest that BMC treatment for CMP is safe and feasible. This therapy was associated with persistent improvements in LV function, LV remodeling, functional class, patients’ survival, and quality of life. Intracoronary infusion of high-dose (> 10⁸) BMSC might be a better therapeutic option for CMP patients. Further evidences are needed to verify our results.