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Preventive Effect of Bone Marrow Mononuclear Cell Transplantation on Acute Myocardial Infarction-Induced Heart Failure: A Meta-analysis of Randomized Controlled Trials

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Abstract

Purpose

Heart failure (HF) is a major complication of acute myocardial infarction (AMI). Transplantation of bone marrow mononuclear cells (BM-MNC) in the setting of AMI has been proposed as a means for myocardial tissue regeneration. Several trials have explored the outcomes of these cells on surrogate end points such as left ventricular ejection fraction (LVEF) in patients with AMI. However, the data regarding the clinical efficacy are infrequent. Here, we performed a meta-analysis investigating the effect of BM-MNCs injection on the rate of hospitalization for HF in the long-term follow-up period.

Methods

PubMed, Scopus, and Cochrane databases were queried with various combinations of keywords through May 2, 2022. A random-effects meta-analysis was performed to calculate risk ratio (RR) and 95% confidence interval (CI) of hospitalization for HF, all-cause mortality, and stroke rate. Subgroup analyses for hospitalization based on time and cell dose were performed.

Results

A total of 2150 patients with AMI across 22 trials were included for quantitative synthesis. At long-term follow-up, AMI patients treated with an intracoronary injection of BM-MNCs were less likely to be hospitalized for heart failure compared to the control group receiving standard treatment (RR = 0.54, 95% CI = [0.37; 0.78], p = 0.002). There was no association between BM-MNC therapy and all-cause mortality (RR = 0.69, 95% CI = [0.47; 1.01], p = 0.05) and stroke (RR = 1.12, 95% CI= [0.24; 5.21], p = 0.85).

Conclusion

Autologous injection of BM-MNC in the setting of AMI may be associated with decreased risk of hospitalization of heart failure in the long term. However, its effect on all-cause mortality and stroke rate is questionable.

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Data Availability

The data underlying this article will be shared on reasonable request to the corresponding author.

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Funding

This study was not supported by any grant from funding agencies.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, School of Medicine, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran

    Alireza Hosseinpour & Armin Attar

  2. Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

    Hamidreza Hosseinpour

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  1. Alireza Hosseinpour
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Contributions

AA contributed to the concept and design of the study. AH contributed to the screening process and statistical analysis. The first draft of the manuscript was written by AH and HH. AA and AH revised the final draft. AA, AH, and HH contributed to manuscript writing and preparing the final version of the manuscript.

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Correspondence to Armin Attar.

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Hosseinpour, A., Hosseinpour, H. & Attar, A. Preventive Effect of Bone Marrow Mononuclear Cell Transplantation on Acute Myocardial Infarction-Induced Heart Failure: A Meta-analysis of Randomized Controlled Trials. Cardiovasc Drugs Ther 37, 1143–1153 (2023). https://doi.org/10.1007/s10557-022-07359-3

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