Abstract

Introduction: The role of bone marrow cell transplant in ischemic heart failure is being increasingly recognized. Multiple studies have been published their experience, demonstrating varying results. We aimed to perform a meta-analysis of the published literature.

Methods: We searched Pubmed, EBSCO and Cochrane databases for terms “bone marrow transplant”, “stem cell transplant”, “heart failure”, “cardiac failure” and their combinations. Only studies comparing bone marrow cell transplantation via intracoronary route to placebo, and those with 6 month follow up data were included. Studies in languages other than English were excluded.

Results: Ejection fraction was significantly increased with the use of bone marrow cell transplant compared to placebo (mean difference 6.16% 95%CI 4.16 to 8.16, p < 0.00001). No significant differences were observed in left ventricular (LV) end-systolic volume (mean difference -1.58 ml 95%CI -4.98 to 1.82, p = 0.36), LV end-diastolic volume (mean difference -0.77 ml 95%CI -3.75 to 2.22, p = 0.61) and mortality (odds ratio 1.08 95%CI 0.26 to 4.56, p = 0.92). Results of heterogeneity analysis showed significant heterogeneity only in the analysis of left ventricular ejection fraction (p = 0.01).

Conclusion: As compared to placebo, intracoronary bone marrow cell transplant is associated with a 6% improvement left ventricular ejection fraction in ischemic heart failure patients at 6 month follow up.

Keywords: Bone marrow transplant; Heart failure; Intracoronary; Intramyocardial; Transepicardial