title: [Systematic review on safety of intracoronary autologous bone marrow stem cells transfer in patients with acute myocardial infarction].
abstract: OBJECTIVE
  To estimate the safety of intracoronary autologous bone marrow stem cells (BMSC) transfer in patients with acute myocardial infarction.
  
  
  METHODS
  A systematic literature search of PubMed, MEDLINE, Cochrane EBM, BIOSIS, EMBASE and Chinese Journal Full-text Database between January 1990 and May 2007, was performed. Inclusion criteria required that patients received intracoronary BMSC transfer after coronary reperfusion therapy for primary acute myocardial infarction; study design involved patient randomization and matching placebo group as well as detailed safety data with more than 3 months follow-up results.
  
  
  RESULTS
  A total of 5 trials with 620 patients were available for analysis. The pooled statistics showed similar results between BMSC and placebo groups in terms of occurrence of the individual clinical adverse events and the combined endpoint death, recurrence of myocardial infarction, or revascularization procedures. The combined endpoint death, recurrence of myocardial infarction, revascularization procedures, or rehospitalization for heart failure was significantly reduced in the BMSC group compared with the control group at more than one year follow-up (OR = 0.45, 95%CI 0.28 - 0.74, P = 0.002). Likewise, the occurrence of revascularization and the combined endpoint death, recurrence of myocardial infarction, or revascularization procedures were significantly reduced when BMSC transplantation was performed between 4 and 7 days after primary percutaneous coronary intervention (PCI) (OR = 0.60, 95%CI 0.37 - 0.97, P = 0.04; OR = 0.58, 95%CI 0.37 - 0.91, P = 0.02, respectively). In contrast, there was a significant increase in the combined endpoint revascularization and recurrence of myocardial infarction when BMSC transplantation was performed within 24 hours after PCI (OR = 2.56, 95%CI 1.03 - 6.34, P = 0.04).
  
  
  CONCLUSIONS
  Post PCI intracoronary autologous BMSC transplantation in patients with acute myocardial infarction is safe, especially in patients received BMSC transplantation between 4 and 7 days after primary PCI than patients received BMSC transplantation within 24 hours post PCI.
authors.affiliation: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.
authors.forename: Shu-Ning
authors.initials: SN
authors.lastname: Zhang
authors.forename: Ai-jun
authors.initials: AJ
authors.lastname: Sun
authors.forename: Jun-bo
authors.initials: JB
authors.lastname: Ge
authors.forename: Kang
authors.initials: K
authors.lastname: Yao
authors.forename: Zhe-yong
authors.initials: ZY
authors.lastname: Huang
authors.forename: Ke-qiang
authors.initials: KQ
authors.lastname: Wang
authors.forename: Yun-zeng
authors.initials: YZ
authors.lastname: Zou
mesh_terms: D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D014182:Transplantation, Autologous; D020257:Ventricular Remodeling