Autologous transplantation of blood-derived stem/progenitor cells for ischaemic heart disease

Aims: Early clinical trials suggest that blood-derived stem/progenitor cells (including peripheral blood-derived stem cells and circulating progenitor cells) may have a positive impact on patients with ischaemic heart disease (IHD). The therapeutic effects of these cells remain unclear, considering the inconsistent results of several clinical trials. The objective of this meta-analysis was to evaluate the effects of autologous blood-derived stem/progenitor cells on improvement of cardiac functional parameters on the basis of a synthesis of the data generated by randomised controlled clinical trials (RCTs) of patients with IHD. Methods: Randomised controlled clinical trials were identified in the MEDLINE, the Cochrane Central Register of Controlled Trials, EBSCO, EMBASE, reviews and reference lists of relevant articles. All searching was completed on 12 January 2011. Weighted mean difference was calculated for changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic and end-systolic volumes (LVEDV and LVESV) using a fixed effects model. Results: Of the 1587 citations identified in the literature search, six RCTs were finally analysed. Compared with controls, blood-derived stem/progenitor cells infusion was safe and improved LVEF by 3.72% (95% CI: 1.98-5.46%; p < 0.0001). However, no significant improvement in LVEDV and LVESV at follow-up was observed. Conclusions: Available evidence showed moderate improvements over conventional therapy in LVEF of blood-derived stem/progenitor cells transplantation in patients with IHD, and supports further RCTs with higher quality.