Intracoronary infusion of bone marrow-derived mononuclear cells contributes to longstanding improvements of left ventricular performance and remodelling after acute myocardial infarction: a meta-analysis.
BACKGROUND
Conflicting results exist now on the sustained effects of intracoronary bone marrow-derived mononuclear cells (BMMNCs) infusion in patients with acute myocardial infarction (AMI).


METHODS
Systematical literature search of PubMed, ISI Web of Science, and Cochrane databases was conducted. We included the randomised controlled trials with at least 12-month follow-up data for AMI patients receiving primary percutaneous coronary intervention in addition to intracoronary BMMNCs transfer or not (the control). Summary statistics were calculated using random-effects models.


RESULTS
A total of 10 trials with 757 patients were available for analysis. The pooled statistics showed intracoronary administration of BMMNCs significantly improved post-infarction left ventricular ejection fraction (weight mean differences [WMD]=4.04%, 95% confidence intervals [CI], 3.01-5.07%; p<0.01), and attenuated the enlargement of left ventricular end-diastolic volume (WMD=-6.13 ml, 95%CI, -10.56 ml to -1.69 ml; p=0.007) as well as infarct size (WMD=-2.47%, 95%CI, -3.79% to -1.15%; p=0.0002). However, for the major adverse clinical events (MACEs), there appeared to be neutral results (between-group differences of p>0.10).


CONCLUSIONS
Intracoronary BMMNCs infusion leads to longstanding and moderate improvements of post-infarction left ventricular performance as well as remodelling. Meanwhile, the procedure did not increase the risk of MACEs.
Department of Cardiovascular Diseases, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China.
Zhong
Z
Ye
Bi-Li
BL
Zhang
Xian-Xian
XX
Zhao
Yong-Wen
YW
Qin
Hong
H
Wu
Jiang
J
Cao
Jian-Liang
JL
Zhang
Jian-Qiang
JQ
Hu
Xing
X
Zheng
Rong-Liang
RL
Xu
D000818:Animals; D001854:Bone Marrow Cells; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000637:transplantation*; D009203:Myocardial Infarction / Q000503:physiopathology* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume; D020257:Ventricular Remodeling