Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis

Background. The optimal timing for Bone Marrow Stem Cells (BMCs) therapy following acute myocardial infarction (AMI) remains unclear. Aims. To synthesize the evidence from trials using a multiple-treatment comparison method, thereby permitting a broader comparison across multiple timing of BMCs ther...

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Main Authors: Bei Liu, Chong-Yang Duan, Cheng-Feng Luo, Cai-Wen Ou, Zhi-Ye Wu, Jian-Wu Zhang, Xiao-Bin Ni, Ping-Yan Chen, Min-Sheng Chen
Format: Article
Language:English
Published: Wiley 2016-01-01
Series:Stem Cells International
Online Access:http://dx.doi.org/10.1155/2016/1031794
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author Bei Liu
Chong-Yang Duan
Cheng-Feng Luo
Cai-Wen Ou
Zhi-Ye Wu
Jian-Wu Zhang
Xiao-Bin Ni
Ping-Yan Chen
Min-Sheng Chen
author_facet Bei Liu
Chong-Yang Duan
Cheng-Feng Luo
Cai-Wen Ou
Zhi-Ye Wu
Jian-Wu Zhang
Xiao-Bin Ni
Ping-Yan Chen
Min-Sheng Chen
author_sort Bei Liu
collection DOAJ
description Background. The optimal timing for Bone Marrow Stem Cells (BMCs) therapy following acute myocardial infarction (AMI) remains unclear. Aims. To synthesize the evidence from trials using a multiple-treatment comparison method, thereby permitting a broader comparison across multiple timing of BMCs therapy. Methods and Results. Randomized controlled trials in patients with AMI receiving BMCs therapy were identified from PubMed, Ovid LWW, BIOSIS Previews, and the Cochrane Library through January 2015. 2 035 patients of 31 studies included in our analysis were allocated to 5 groups’ treatments: 1~3 days, 4~7 days, 8~14 days, 15~30 days, or placebo/control group. The multiple-treatment meta-analysis showed that 4~7 days’ group could lead to significantly increased left ventricular ejection fraction (LVEF) as compared with control (mean of MDs and 95% CI: 6 months, 3.05 (0.92~5.25); 12 months, 4.18 (2.30~5.84)). Only 4~7 days led to significant reduction of MACEs compared with control (OR and 95% CI 0.34 (0.13~0.96)) for 12-months follow-up. In simulated comparisons, the 4~7 days’ group ranked better than other timing groups for improvement of LVEF or reduction of the incidence of major adverse cardiac events. Conclusions. 4~7 days after AMI might be the optimal timing for cell therapy in terms of efficacy or safety.
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spelling doaj-art-6927d3b59be04095a7208cefc16f418d2025-08-20T02:35:24ZengWileyStem Cells International1687-966X1687-96782016-01-01201610.1155/2016/10317941031794Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-AnalysisBei Liu0Chong-Yang Duan1Cheng-Feng Luo2Cai-Wen Ou3Zhi-Ye Wu4Jian-Wu Zhang5Xiao-Bin Ni6Ping-Yan Chen7Min-Sheng Chen8Department of Cardiology, Zhu Jiang Hospital, Southern Medical University, Guangzhou 510280, ChinaDepartment of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, ChinaDepartment of Cardiology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou 510280, ChinaSouthern Medical University, Guangzhou 510515, ChinaDepartment of Cardiology, Zhu Jiang Hospital, Southern Medical University, Guangzhou 510280, ChinaDepartment of Cardiology, Zhu Jiang Hospital, Southern Medical University, Guangzhou 510280, ChinaDepartment of Cardiology, Zhu Jiang Hospital, Southern Medical University, Guangzhou 510280, ChinaDepartment of Biostatistics, School of Public Health and Tropical Medicine, Southern Medical University, Guangzhou 510515, ChinaDepartment of Cardiology, Zhu Jiang Hospital, Southern Medical University, Guangzhou 510280, ChinaBackground. The optimal timing for Bone Marrow Stem Cells (BMCs) therapy following acute myocardial infarction (AMI) remains unclear. Aims. To synthesize the evidence from trials using a multiple-treatment comparison method, thereby permitting a broader comparison across multiple timing of BMCs therapy. Methods and Results. Randomized controlled trials in patients with AMI receiving BMCs therapy were identified from PubMed, Ovid LWW, BIOSIS Previews, and the Cochrane Library through January 2015. 2 035 patients of 31 studies included in our analysis were allocated to 5 groups’ treatments: 1~3 days, 4~7 days, 8~14 days, 15~30 days, or placebo/control group. The multiple-treatment meta-analysis showed that 4~7 days’ group could lead to significantly increased left ventricular ejection fraction (LVEF) as compared with control (mean of MDs and 95% CI: 6 months, 3.05 (0.92~5.25); 12 months, 4.18 (2.30~5.84)). Only 4~7 days led to significant reduction of MACEs compared with control (OR and 95% CI 0.34 (0.13~0.96)) for 12-months follow-up. In simulated comparisons, the 4~7 days’ group ranked better than other timing groups for improvement of LVEF or reduction of the incidence of major adverse cardiac events. Conclusions. 4~7 days after AMI might be the optimal timing for cell therapy in terms of efficacy or safety.http://dx.doi.org/10.1155/2016/1031794
spellingShingle Bei Liu
Chong-Yang Duan
Cheng-Feng Luo
Cai-Wen Ou
Zhi-Ye Wu
Jian-Wu Zhang
Xiao-Bin Ni
Ping-Yan Chen
Min-Sheng Chen
Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
Stem Cells International
title Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
title_full Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
title_fullStr Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
title_full_unstemmed Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
title_short Impact of Timing following Acute Myocardial Infarction on Efficacy and Safety of Bone Marrow Stem Cells Therapy: A Network Meta-Analysis
title_sort impact of timing following acute myocardial infarction on efficacy and safety of bone marrow stem cells therapy a network meta analysis
url http://dx.doi.org/10.1155/2016/1031794
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