Is stem cell therapy effective for serious heart problems?

  • Cochrane Database Syst Rev

  • from Sarfaroj Khan
  • Clinical Summaries
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Takeaway 

  • Low-quality evidence suggests that stem cell therapy reduces the risk for all-cause mortality at long-term follow-up in people with chronic ischaemic heart disease (CIHD), heart failure (HF) secondary to ischaemic heart disease and refractory angina.

Why this matters 

  • Recent trials investigating the use of cell therapies for CIHD and HF have shown conflicting results.

Key results

  • Pooled results showed that cell therapy was associated with reduction in long-term incidence of:

         — Mortality (≥12 mo) (risk ratio [RR], 0.42; participants, 491; studies, 9).

         — Non-fatal myocardial infarction (RR, 0.38; participants, 345; studies, 5).

         — Arrhythmias (RR, 0.42; participants, 82; studies, 1).

  • There was no evidence that cell therapy affects the risk for:

         — Rehospitalisation for HF (RR, 0.63; participants, 375; studies, 6).

         — Composite incidence of mortality, non-fatal myocardial infarction and rehospitalisation for HF (RR, 0.64; participants, 141; studies, 3).

         — Long-term left ventricular ejection fraction (mean difference, -1.60; participants, 25; studies, 1).

Study design

  • 38 randomised controlled trials covering 1907 participants (1114 cell therapy; 793 control participants) met eligibility criteria after a review on CENTRAL, MEDLINE, Embase, LILACS, CINAHL and various other resources.
  • Funding: None.

Limitations

  • Low-quality evidence.
  • High risk for selection bias.