| Impact of timing on efficacy and safetyof intracoronary autologous bone marrow stem cells transplantation in acute myocardial infarction: a pooled subgroup analysis of randomized controlled trials. | |
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MedLine Citation:
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PMID: 19685520 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Until now there were no clinical studies or systematic reviews to investigate the impact of timing on efficacy and safety of intracoronary bone marrow stem cell (BMSC) transfer in patients with acute myocardial infarction (AMI). HYPOTHESIS: Timing of BMSC administration might play an important role in the therapeutic response in AMI patients. METHODS: A systematic literature search of PubMed, MEDLINE, and Cochrane Evidence-Based Medicine (EBM) databases was made on randomized controlled trials with at least 3-month follow-up data for patients with AMI undergoing emergent percutaneous coronary intervention (PCI) and receiving intracoronary BMSC transfer thereafter. RESULTS: A total of 7 trials with 660 patients were available for analysis. Compared to baseline level, BMSC transfer at 4 to 7 days post-AMI significantly improved left ventricular ejection fraction (LVEF; 4.63% increase, 95% confidence interval [CI]: 1.00%-8.26%, P = 0.01), reduced left ventricular (LV) end-systolic dimensions (95% CI: - 0.53 - 0.02, P = 0.03), decreased the incidences of revascularization (odds ratio [OR]: 0.60, 95% CI: 0.37-0.97, P = 0.04), decreased the cumulative clinical events of death or recurrent myocardial infarction (OR: 0.32, 95% CI: 0.11-0.95, P = 0.04), and decreased culprit artery restenosis or ventricular arrhythmia (OR: 0.59, 95% CI: 0.36-0.96, P = 0.03) however these improvements did not reach statistical significance in emergent transfer trials (within 24 hour post-AMI). Compared with emergent transfer, intracoronary BMSC therapy at 4 to 7 days also significantly reduced the incidence of revascularization (P for interaction = 0.02). CONCLUSIONS: BMSC transfer at 4 to 7 days post-AMI was superior to that within 24 hours in improving LVEF, decreasing LV end-systolic dimensions, and reducing the incidence of revascularization. |
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Authors:
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Shuning Zhang; Aijun Sun; Danling Xu; Kang Yao; Zheyong Huang; Huan Jin; Keqiang Wang; Yunzeng Zou; Junbo Ge |
Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Clinical cardiology Volume: 32 ISSN: 1932-8737 ISO Abbreviation: - Publication Date: 2009 Aug |
Date Detail:
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Created Date: 2009-08-24 Completed Date: 2009-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 458-66 Citation Subset: IM |
Affiliation:
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Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary*
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adverse effects,
mortality Arrhythmias, Cardiac / etiology Bone Marrow Transplantation* / adverse effects, mortality Combined Modality Therapy Coronary Restenosis / etiology Female Humans Logistic Models Male Middle Aged Myocardial Infarction / mortality, physiopathology, surgery, therapy* Odds Ratio Publication Bias Randomized Controlled Trials as Topic Recovery of Function Recurrence Reproducibility of Results Risk Assessment Stroke Volume Thrombosis / etiology Time Factors Transplantation, Autologous Treatment Outcome Ventricular Function, Left |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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