Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis. (13th December 2015)

• Record Type: Journal Article
• Authors: Liu, Bei; Duan, Chong-Yang; Luo, Cheng-Feng; Ou, Cai-Wen; Wu, Zhi-Ye; Zhang, Jian-Wu; Ni, Xiao-Bin; Chen, Ping-Yan; Chen, Min-Sheng
• Other Names: Keating Armand Academic Editor.
• Is Part Of: Stem cells international. Volume 2016(2016)
• Publication Date: 2015-12-13
• Subjects: Stem Cells -- Periodicals; Stem Cells -- Therapeutic use -- Periodicals; Stem Cells -- Transplantation -- Periodicals; 616.0277405
• DOI: 10.1155/2016/1031794
• Languages: English
• ISSNs: 1687-966X

Abstract

Abstract : Background . The optimal timing for Bone Marrow Stem Cells (BMCs) therapy following acute myocardial infarction (AMI) remains unclear. Aims . To synthesize the evidence from trials using a multiple-treatment comparison method, thereby permitting a broader comparison across multiple timing of BMCs therapy. Methods and Results . Randomized controlled trials in patients with AMI receiving BMCs therapy were identified from PubMed, Ovid LWW, BIOSIS Previews, and the Cochrane Library through January 2015. 2 035 patients of 31 studies included in our analysis were allocated to 5 groups' treatments: 1~3 days, 4~7 days, 8~14 days, 15~30 days, or placebo/control group. The multiple-treatment meta-analysis showed that 4~7 days' group could lead to significantly increased left ventricular ejection fraction (LVEF) as compared with control (mean of MDs and 95% CI: 6 months, 3.05 (0.92~5.25); 12 months, 4.18 (2.30~5.84)). Only 4~7 days led to significant reduction of MACEs compared with control (OR and 95% CI 0.34 (0.13~0.96)) for 12-months follow-up. In simulated comparisons, the 4~7 days' group ranked better than other timing groups for improvement of LVEF or reduction of the incidence of major adverse cardiac events. Conclusions . 4~7 days after AMI might be the optimal timing for cell therapy in terms of efficacy or safety.