Zhao Mei, Xue Yanpeng, Tian Qingqing, Deng Yan, Tang Tao
Department of Pharmacy, Sanya Central Hospital (The Third People's Hospital of Hainan Province), Sanya, China.
Institute of Neuroscience, Sino-Russian Medical Research Center, Harbin Medical University, Harbin, China.
Cell Transplant. 2025 Jan-Dec;34:9636897251359773. doi: 10.1177/09636897251359773. Epub 2025 Aug 4.
This meta-analysis evaluated the efficacy of mesenchymal stem cell (MSC) treatment on cardiovascular function and major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI) at various follow-up intervals. Clinical studies comparing MSC therapy with control treatments for AMI were identified from databases including Cochrane, Web of Science, PubMed, Embase, CNKI, and Wanfang, covering publications up to August 2024. Data analysis was conducted using Review Manager 5.4 software. MSC treatment significantly improved left ventricular ejection fraction (LVEF) compared to controls at follow-up intervals <6 months (MD = 3.42; < 0.0001), 6 months (MD = 4.15; = 0.006), and 12 months (MD = 2.77; = 0.006). However, no significant effect on LVEF was observed after 12 months (MD = 3.50; = 0.17). MSC therapy did not significantly affect left ventricular end-diastolic volume (LVEDV) at any interval. Left ventricular end-systolic volume (LVESV) significantly decreased only within the first 6 months (MD = -11.35; = 0.11) but not at subsequent follow-ups. Wall motion score index (WMSI) significantly improved at <6 months (MD = -0.06; < 0.0001), 6 months (MD = -0.04; = 0.006), and >12 months (MD = -0.03; = 0.02). However, the improvement at 12 months was borderline significant (MD = -0.06; = 0.06). MSC therapy showed no significant reduction in MACE (odds ratio [OR] = 1.61; = 0.10). Subgroup analyses indicated intracoronary MSC administration notably improved LVEF (MD = 4.27; < 0.0001), while intravenous MSC administration showed no significant effect. Neither administration route significantly affected MACE outcomes. No publication bias was detected. In conclusion, MSC therapy significantly enhances LVEF and WMSI within the first 12 months post-AMI, with intracoronary administration showing greater efficacy than intravenous delivery. However, MSC treatment did not significantly reduce MACE incidence. Further rigorous clinical trials are needed to confirm these findings.
这项荟萃分析评估了间充质干细胞（MSC）治疗对急性心肌梗死（AMI）患者在不同随访间隔时心血管功能和主要不良心脏事件（MACE）的疗效。通过包括Cochrane、科学网、PubMed、Embase、中国知网和万方在内的数据库，检索了将MSC治疗与AMI对照治疗进行比较的临床研究，涵盖截至2024年8月的出版物。使用Review Manager 5.4软件进行数据分析。与对照组相比，在随访间隔<6个月（MD = 3.42；P < 0.0001）、6个月（MD = 4.15；P = 0.006）和12个月（MD = 2.77；P = 0.006）时，MSC治疗显著改善了左心室射血分数（LVEF）。然而，12个月后未观察到对LVEF有显著影响（MD = 3.50；P = 0.17）。在任何随访间隔，MSC治疗对左心室舒张末期容积（LVEDV）均无显著影响。仅在最初6个月内左心室收缩末期容积（LVESV）显著降低（MD = -11.35；P = 0.11），但在随后的随访中未降低。在<6个月（MD = -0.06；P < 0.0001）、6个月（MD = -0.04；P = 0.006）和>12个月（MD = -0.03；P = 0.02）时，壁运动评分指数（WMSI）显著改善。然而，12个月时的改善接近显著（MD = -0.06；P = 0.06）。MSC治疗未显示出MACE有显著降低（优势比[OR] = 1.61；P = 0.10）。亚组分析表明，冠状动脉内给予MSC显著改善了LVEF（MD = 4.27；P < 0.0001），而静脉内给予MSC未显示出显著效果。两种给药途径均未对MACE结果产生显著影响。未检测到发表偏倚。总之，MSC治疗在AMI后最初12个月内显著提高了LVEF和WMSI，冠状动脉内给药比静脉给药显示出更高的疗效。然而，MSC治疗未显著降低MACE发生率。需要进一步严格的临床试验来证实这些发现。
