Abstract Body (Do not enter title and authors here): Introduction
Coronary heart disease(CHD) and myocardial infarction(MI) cost American healthcare $99 billion annually. In the US, 20.5 million adults over 20 years of age suffer from CHD, and 9.3 million from MI. MI causes cardiac myocyte death and scarring, leading to ischemic cardiomyopathy (ICMY), heart failure(HF), and arrhythmia. Current treatments improve perfusion and prevent remodeling but cannot reverse scarring. Stem cell therapy(SCT) aims to replace scarred myocardium with viable tissue, preventing complications like ICMY and HF.
Aims
Evaluating the efficacy of SCT, in treating MI and preventing ICMY and HF. Efficacy was measured after 6 months, 1 year, and the long term.
Methods
We followed the PRISMA protocol and guidelines to identify all human clinical trials on PubMed since 2010 that used SCT in adults with MI. Observational, non-human studies and isolated case reports were excluded. Our population of interest: adults with MI and SCT were compared to the control group of standard therapy alone(ST). Cardio sphere-derived autologous stem cells, Autologous Bone Marrow Stem Cell Therapy, Bone marrow-derived mononuclear cells via anterograde intra-arterial coronary delivery, Intracoronary infusion of autologous CD34 (+) cell, and Mesenchymal Stem/Stromal Cells were utilized in these trials. The primary outcome measured was efficacy: defined as an increase in Left Ventricular Ejection Fraction(LVEF) by >10%.
Results
More than 3000 articles were reviewed, and after applying rigorous inclusion and exclusion criteria, we narrowed down to 32 articles with 2613 patients for qualitative and quantitative analysis. We found an increase in LVEF of >10% with optimal treatment after 12 months of management in the SCT (P<0.05). No significant difference in adverse effects was observed comparing SCT to ST. Reduction in scar size and increase in viable myocardium with improved regional function of infarcted myocardium were observed with SCT.
Discussion
CHD and MI are both widespread and impose a significant economic burden on our society. Therefore, it is vital to explore novel treatments for enhancing the survival rate and reducing the negative health outcomes linked to CHD. Our study shows that SCT can lower long-term complications such as ICMY and HF in patients with MI, without creating any substantial negative effects. Hence, additional research, such as extensive multi-center clinical trials, is necessary to examine the potential of SCT in treating MI.