Kang Sheng, Yang Yue-Jin, Li Chong-Jian, Gao Run-Lin
Department of Cardiology, Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Coron Artery Dis. 2008 Aug;19(5):327-35. doi: 10.1097/MCA.0b013e328300dbd3.
Experimental and clinical studies have suggested that intracoronary infusion of bone marrow-derived stem/progenitor cells (BMC) may improve left ventricular function after acute myocardial infarction (AMI). We conducted a systematic review and meta-analysis to investigate the efficacy and safety of BMC therapy on global left ventricular function in AMI.
A systematic literature search of MEDLINE, Cochrane Controlled Trials Register, EMBASE, Science Citation Index, and PUBMED from their inception to March 2007 was conducted using specific search terms. Reference lists of papers and reviews on the topic were further searched. Finally, six randomized controlled trials that comprised 517 patients were eligible for further meta-analysis. We used a standardized protocol to extract information on the included studies.
Compared with the control groups, BMC therapy produced a slight improvement of the follow-up left ventricular ejection fraction (LVEF) [2.53%, 95% confidence interval (CI): 0.67-4.39, P=0.008] between 3 and 6 months. Similarly, BMC therapy also significantly improved the LVEF change from baseline to follow-up [2.88%, 95%CI: 1.69-4.08, P=0.000] compared to control groups, and the heterogeneity across the studies with regards to the follow-up LVEF (P=0.696) and the LVEF change (P=0.179). Major adverse cardiovascular events, including ventricular arrhythmia, rehospitalization for heart failure, and the composite of other cardiovascular events (cardiac death, recurrent myocardial infarction, infarct-vessel revascularization procedure, and stroke), were not significantly different between BMC therapy and control groups [relative risk (RR): 1.19, 95%CI: 0.68-2.06; RR: 1.79, 95%CI: 0.62-5.17; and RR: 1.05, 95%CI: 0.81-1.35, respectively].
On the basis of present evidence, intracoronary BMC infusion in patients with AMI seems to be safe and associated with slight improvement of the left ventricular ejection fraction at 3-6 months' follow-up.
实验和临床研究表明，急性心肌梗死（AMI）后冠状动脉内注入骨髓源干细胞/祖细胞（BMC）可能改善左心室功能。我们进行了一项系统评价和荟萃分析，以研究BMC治疗对AMI患者整体左心室功能的疗效和安全性。
使用特定检索词对MEDLINE、Cochrane对照试验注册库、EMBASE、科学引文索引和PUBMED从创建至2007年3月进行系统文献检索。进一步检索该主题的论文和综述的参考文献列表。最后，六项随机对照试验（共517例患者）符合进一步荟萃分析的条件。我们使用标准化方案提取纳入研究的信息。
与对照组相比，BMC治疗在3至6个月时使随访左心室射血分数（LVEF）略有改善[2.53%，95%置信区间（CI）：0.67 - 4.39，P = 0.008]。同样，与对照组相比，BMC治疗也显著改善了从基线到随访的LVEF变化[2.88%，95%CI：1.69 - 4.08，P = 0.000]，并且各研究在随访LVEF（P = 0.696）和LVEF变化（P = 0.179）方面的异质性。主要不良心血管事件，包括室性心律失常、因心力衰竭再次住院以及其他心血管事件（心源性死亡、再发心肌梗死、梗死血管血运重建术和中风）的复合事件，在BMC治疗组和对照组之间无显著差异[相对危险度（RR）：1.19，95%CI：0.68 - 2.06；RR：1.79，95%CI：0.
