Abstract 14451: Bone Marrow Cell Therapy Improves Cardiac Function, Survival, and Clinical Outcomes in Patients With Chronic Ischemic Heart Disease

• Published in: Circulation (New York, N.Y.) Vol. 142; no. Suppl_3 Suppl 3; p. A14451
• Main Authors: Ha, Jane, Afzal, Muhammad R, Samanta, Anweshan, Zuba-Surma, Ewa, Yoo, Ji, Dawn, Buddhadeb
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 17.11.2020
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.14451

IntroductionThe effects of bone marrow cell (BMC) therapy in patients with chronic ischemic heart disease (CIHD) remain controversial.HypothesisWe hypothesized that injection of BMCs in patients with CIHD would improve left ventricular (LV) structure and function. We also hypothesized that BMC therapy would improve clinical outcomes in CIHD patients.MethodsWe performed a systemic review and meta-analysis of pooled data from published randomized controlled trials (RCTs) that evaluated the efficacy of BMC administration in patients with CIHD. The effects of BMC injection on LV ejection fraction (LVEF), LV end-systolic volume (LVESV), LV end-diastolic volume (LVEDV), infarct size, and patient outcomes were analyzed using random-effects meta-analysis.ResultsThe literature search yielded 30 RCTs enrolling 1,548 patients. Transplantation of BMCs resulted in an improvement in LVEF in cell-treated patients compared with controls (2.89%; 95% confidence interval (CI)1.80 to 3.97; P<0.001). There was a trend toward reduced LVESV (-4.96 ml; 95% CI-11.64 to 1.71 ml; P= 0.14) and LVEDV (-5.95 ml; 95% CI-12.09 to 0.18 ml; P=0.06). The improvement in LVEDV was more pronounced (-7.42 ml; 95% CI-13.68 to -1.17ml; P=0.02) in patients with baseline LVEF <40%, indicating improved LV remodeling. BMC injection was also associated with marked reduction in the risk of all-cause mortality, rehospitalization due to heart failure, and ventricular arrhythmias in CIHD patients.ConclusionsBMC injection improves cardiac function and remodeling in patients with CIHD. These benefits are more pronounced in patients with LVEF <40% at baseline. Perhaps more importantly, BMC therapy also improves clinical outcomes that are critically important for this patient population with LV dysfunction, including survival, rehospitalization due to heart failure, and ventricular arrhythmias.