Meta-Analysis of Cell Therapy Trials for Patients with Heart Failure - An Update
Rationale: Cell-based therapies are a promising intervention for the treatment of heart failure (HF) secondary to ischemic and non-ischemic cardiomyopathy. However, the clinical efficacy of such new treatment requires further evaluation.
Objective: To assess available clinical evidence on the safety and efficacy of cell-based therapies for HF.
Methods and Results: Electronic databases (CENTRAL, DARE, NHSEED & HTA, PubMed, MEDLINE, EMBASE, CINAHL, LILACS, KoreaMed, PakMediNet, IndMed and the Transfusion Evidence Library) were searched for relevant randomized controlled trials to June 2014. Trials of participants with HF and where the administration of any dose of autologous cells by any delivery route was compared to no intervention or placebo were eligible for inclusion. Primary outcomes were defined as mortality and rehospitalization due to HF. Secondary outcomes included performance status, quality of life, incidence of arrhythmias, brain natriuretic peptide levels, left ventricular ejection fraction, myocardial perfusion and adverse events. Thirty-one independent trials (1,521 participants) were included. The treatment significantly reduced the risk of mortality and rehospitalization due to HF. There was a significant improvement in favour of stem cell treatment in performance status and exercise capacity, left ventricular ejection fraction and quality of life. The treatment was also associated with a reduction of brain natriuretic peptide levels and no increase in the incidence of arrhythmias. However, there was considerable risk of performance, selection and reporting bias amongst the included trials.
Conclusions: This study shows evidence that autologous cell therapy may be beneficial for patients suffering from HF, but further evidence is required.
- cell therapy
- ischemic cardiomyopathy
- non-ischemic dilated cardiomyopathy
- stem cell
- heart failure
- randomized controlled trial
- Received November 15, 2014.
- Revision received January 8, 2015.
- Accepted January 20, 2015.