PMID- 32893120
OWN - NLM
STAT- MEDLINE
DCOM- 20210210
LR  - 20210210
IS  - 1477-2566 (Electronic)
IS  - 1465-3249 (Linking)
VI  - 22
IP  - 12
DP  - 2020 Dec
TI  - Effects of stem cells on non-ischemic cardiomyopathy: a systematic review and 
      meta-analysis of randomized controlled trials.
PG  - 699-711
LID - S1465-3249(20)30780-5 [pii]
LID - 10.1016/j.jcyt.2020.06.006 [doi]
AB  - BACKGROUND AIMS: To assess the impacts of stem cell therapy on clinical outcomes 
      in patients with non-ischemic cardiomyopathy (NICM). The effect of stem cell 
      therapy on prognosis is unclear and controversial. METHODS: The authors performed 
      a systematic review and meta-analysis of the effects of autologous stem cell 
      transplantation in patients with NICM on a composite outcome of all-cause 
      mortality and heart transplantation, left ventricular ejection fraction (LVEF), 
      left ventricular end-diastolic diameter (LVEDD), New York Heart Association 
      (NYHA) classification, 6-minute walk test (6-MWT) distance and serum brain 
      natriuretic peptide (BNP) level, considering studies published before March 19, 
      2020. RESULTS: Twelve trials with 623 subjects met inclusion criteria. Compared 
      with the control group, stem cell therapy improved LVEF (weighted mean difference 
      [WMD], 4.08%, 95% confidence interval [CI], 1.93-6.23, P = 0.0002) and 6-MWT 
      distance (WMD, 101.49 m, 95% CI, 45.62-157.35, P = 0.0004) and reduced BNP level 
      (-294.94 pg/mL, 95% CI, -383.97 to -205.90, P < 0.00001) and NYHA classification 
      (-0.70, 95% CI, -0.98 to -0.43, P < 0.00001). However, LVEDD showed no 
      significant difference between the two groups (WMD, -0.09 cm, 95% CI, -0.23 to 
      0.06, P = 0.25). In 10 studies (535 subjects) employing the intracoronary route 
      for cell delivery, mortality and heart transplantation were decreased (risk ratio 
      [RR], 0.73, 95% CI, 0.52-1.00, P = 0.05). Furthermore, in four studies (248 
      subjects) with peripheral CD34+ cells, either all-cause mortality (RR, 0.44, 95% 
      CI, 0.23-0.86, P = 0.02) or mortality and heart transplantation (RR, 0.45, 95% 
      CI, 0.27-0.77, P = 0.003) improved in the treatment group compared with the 
      control. The trial sequential analysis suggested the information size of LVEF, 
      6-WMT and BNP has been adequate for evidencing the benefits of stem cells on 
      NICM. However, to determine the potential survival benefit, more clinical data 
      are required to make the statistical significance in meta-analysis more 
      conclusive. CONCLUSIONS: This meta-analysis demonstrates that stem cell therapy 
      may improve survival, exercise capacity and cardiac ejection fraction in NICM, 
      which suggests that stem cells are a promising option for NICM treatment.
CI  - Copyright (c) 2020 International Society for Cell & Gene Therapy. Published by 
      Elsevier Inc. All rights reserved.
FAU - Xia, Liang
AU  - Xia L
AD  - Department of Clinical Medicine, School of Medicine, Zhejiang University City 
      College, Hangzhou, China. Electronic address: icewater20042005@aliyun.com.
FAU - Zeng, LingHui
AU  - Zeng L
AD  - Department of Pharmacology, School of Medicine, Zhejiang University City College, 
      Hangzhou, China.
FAU - Pan, JianPing
AU  - Pan J
AD  - Department of Clinical Medicine, School of Medicine, Zhejiang University City 
      College, Hangzhou, China.
FAU - Ding, YueMin
AU  - Ding Y
AD  - Department of Clinical Medicine, School of Medicine, Zhejiang University City 
      College, Hangzhou, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20200904
PL  - England
TA  - Cytotherapy
JT  - Cytotherapy
JID - 100895309
SB  - IM
MH  - Cardiomyopathies/etiology/mortality/physiopathology/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/*complications/physiopathology
MH  - Publication Bias
MH  - Randomized Controlled Trials as Topic
MH  - *Stem Cell Transplantation/adverse effects
MH  - Stroke Volume/drug effects
MH  - Transplantation, Autologous
MH  - Walk Test
OTO - NOTNLM
OT  - cardiomyopathy
OT  - meta-analysis
OT  - stem cell transplantation
OT  - trial sequential analysis
EDAT- 2020/09/08 06:00
MHDA- 2021/02/11 06:00
CRDT- 2020/09/07 05:32
PHST- 2020/03/19 00:00 [received]
PHST- 2020/06/01 00:00 [revised]
PHST- 2020/06/19 00:00 [accepted]
PHST- 2020/09/08 06:00 [pubmed]
PHST- 2021/02/11 06:00 [medline]
PHST- 2020/09/07 05:32 [entrez]
AID - S1465-3249(20)30780-5 [pii]
AID - 10.1016/j.jcyt.2020.06.006 [doi]
PST - ppublish
SO  - Cytotherapy. 2020 Dec;22(12):699-711. doi: 10.1016/j.jcyt.2020.06.006. Epub 2020 
      Sep 4.