Efficacy of Stem Cell Transplantation in Cardiac Regeneration and Function in Ischemic Heart Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Abstract Body (Do not enter title and authors here): Background Myocardial ischemia remains a significant global health concern for cardiovascular morbidity and mortality. In addition to the traditional treatment modalities, stem cell transplantation is emerging as a promising therapeutic intervention for cardiac regeneration and functional recovery. Our study evaluated the efficacy and clinical impact of SCT by reducing infarct scar size and improving cardiac function. The secondary objectives are to compare stem cell types, identify optimal transplantation strategies, and address safety and feasibility. Method Randomized controlled trials from January 2000 to July 2023 were collected from PubMed, Cochrane, Google Scholar, and Elsevier. Based on criteria and evidence quality, screening and selection were done. A RevMan analysis was done. Infarct size, LVEF, LVESV, LVEDV, and mortality were measured. Comparator variables included placebo, medical therapy, CABG, and other types of stem cells. Randomization, allocation concealment, blinding, and therapeutic interventions differed among trials. Heterogeneity and publication bias were assessed using random-effects model and funnel plots. Sensitivity analysis and meta-regression identified outcome variability. Results Seventeen studies (n = 1022 patients) met the inclusion criteria, encompassing various cell types, doses, and administration routes. Compared to controls, SCT greatly enhanced LVEF (MD: 3.39, 95% CI: 1.05 to 5.73, p = 0.005) and reduced infarct size (MD: 14.23, 95% CI: 7.12 to 21.35, p<0.0001) with an average dose of 2.03 x 107 cells/ml injected intracoronarily directly into the infarcted myocardium or the target vessel. LVESV (MD: -2.63, 95% CI: -7.99 to 2.73, p = 0.34) or LVEDV (MD: -2.00, 95% CI: -4.40 to 0.40, p = 0.10) did not improve. Differences in mortality rates were insignificant (OR: 0.71, 95% CI: 0.29 to 1.74, p = 0.46). A diverse range of patients was included, leading to moderate heterogeneity (I^2 = 52%). Conclusion SCT shows potential benefits for cardiac regeneration and functional improvement. The analysis is robust, with no publication bias and mild attrition bias issues. Due to low mortality, safety was comparable to conventional therapy. These findings highlight the need for SCT strategy optimization and long-term clinical outcome studies.
Shivani, Ravipati
( Dr. P. S. I. Medical college
, Vijayawada
, India
)
Baskara Salian, Rishabh
( Kasturba Medical College Mangalore
, Mangalore
, India
)
Suvvari, Tarun Kumar
( Squad Medicine and Research
, SRIKAKULAM
, India
)
Nandipi, Vibha Sri
( Navodaya Medical College, Raichur, Karnataka, India
, Karnataka
, India
)
Mathew, Bejoi
( Sri devaraj urs medical College, tamaka, Karanataka, Indi
, Karanataka
, India
)
Michael, Anita
( PSG Institute of Medical Sciences and Research, Coimbatore, India
, Coimbatore
, India
)
Vasini, Vindhya
( Konaseema Institute of Medical Sciences and Research Foundation, India
, Andhra Pradesh
, India
)
Banerjee, Sumitaksha
( 7Burdwan Medical College, Baburbag, West Bengal, India
, West Bengal
, India
)
Kaur, Sakoon
( Government Medical College, Patiala, Punjab, India
, Punjab
, India
)
Konakanchi, Venkata Sai Bhargav Pradeep
( Andhra Medical College, Visakhapatnam, , India
, Andhra Pradesh
, India
)
Author Disclosures:
Ravipati Shivani:DO NOT have relevant financial relationships
| Rishabh Baskara Salian:DO NOT have relevant financial relationships
| Tarun Kumar Suvvari:DO NOT have relevant financial relationships
| Osama Ahmad:DO NOT have relevant financial relationships
| Vibha Sri Nandipi:No Answer
| Bejoi Mathew:DO NOT have relevant financial relationships
| ANITA MICHAEL:DO NOT have relevant financial relationships
| Vindhya Vasini:No Answer
| Sumitaksha Banerjee:No Answer
| Sakoon Kaur:DO NOT have relevant financial relationships
| Venkata Sai Bhargav Pradeep Konakanchi:DO NOT have relevant financial relationships
