Are Selected Bone Marrow Stem Cells More Effective than Unselected Ones in Patients with Chronic Myocardial Infarction?Hyunsuk Jeong1, Hyeon Woo Yim1*, Hun-Jun Park2, Sona Jeong3 and Hyun-bin Kim4
- Corresponding Author:
- Hyeon Woo Yim, MD, PhD
Professor, Department of Preventive Medicine
The Catholic University of Korea College of Medicine
505 Banpo-dong, Seocho-gu, Seoul, Republic of Korea
E-mail: [email protected]
Received Date: December 26, 2013; Accepted Date: January 23, 2014; Published Date: January 25, 2014
Citation: Jeong H, Yim HW, Park HJ, Jeong S, Kim H (2014) Are Selected Bone Marrow Stem Cells More Effective than Unselected Ones in Patients with Chronic Myocardial Infarction? J Stem Cell Res Ther 4:160. doi:10.4172/2157-7633.1000160
Copyright: © 2014 Jeong H, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: The aim of the study was to examine the effectiveness of selected bone marrow-derived stem cell (BMSC) on improving Left Ventricular Ejection Fraction (LVEF) from Randomized Controlled Trials (RCTs) to treat patients with Chronic Myocardial Infarction (CMI). Methods: We searched Medline from 1946 to March 2012 for studies of BMSC transplantation in patients with CMI. The included studies met the following criteria: RCTs, CMI patients who received Coronary Artery Bypass Graft (CABG), BMSC were infused intramuscularly, cell injection in peri-infarct zone, and studies that had up to 6 month follow-up. Results: The initial search identified 8,433 references, of which 7 RCTs met the inclusion criteria. Selected bone marrow stem cells were injected in three of the 7 trials while unselected BMSC was injected to the treatment group in the rest 4 trials. The treatment effects of the studies in which the treatment group was injected with CD34+ and CD133+ were greater than the studies that used unselected BMSC (7.66%, 95% CI: 4.16-11.15 vs. 4.77%; 95% CI: 2.08-7.46). Planned sub-group analyses revealed that the treatment effects on improvement in LVEF differed according to the measurement tools used on outcome assessment, treatment blindness, and methods of surgery. Conclusion: Selected BMSC appeared to show more effective than unselected BMSC. However, the intervention effect of selected BMSC might be overestimated because the studies tended to use less rigorous designs, less precise outcome measures, and different methods of surgery than those using unselected BMSC. Therefore these treatment effects of selected BMSC should be interpreted cautiously.