PMID- 38033439
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231202
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 11
DP  - 2023 Nov
TI  - The Safety and Efficacy of Human Umbilical Cord-Derived Mesenchymal Stem Cells in 
      Patients With Heart Failure and Myocardial Infarction: A Meta-Analysis of 
      Clinical Trials.
PG  - e49645
LID - 10.7759/cureus.49645 [doi]
LID - e49645
AB  - Evidence from preclinical and clinical studies suggests that human umbilical 
      cord-derived mesenchymal stromal cells (HUC-MSCs) may be useful in treating heart 
      failure and acute myocardial infarction (MI). However, the effects of stem cell 
      therapy on patients with heart failure remain the subject of ongoing controversy, 
      and the safety and effectiveness of HUC-MSCs therapy have not yet been proven. To 
      date, there has been no systematic overview and meta-analysis of clinical studies 
      using HUC-MSCs therapy for heart failure and MI. The purpose of this study is to 
      assess the safety and efficacy of HUC-MSC therapy versus a placebo in patients 
      with heart failure and MI. While preparing this systematic review and 
      meta-analysis, we adhered to the Preferred Reporting Items for Systematic Reviews 
      and Meta-Analyses guidelines. A computer literature search of PubMed was 
      performed. We considered randomized controlled trials (RCTs) that reported data 
      on the safety and efficacy of HUC-MSC transplantation in patients with heart 
      failure and MI. Two investigators independently searched the literature, 
      extracted data, and rated the quality of the included research. Pooled data were 
      analyzed using the fixed-effect model or the random-effect model in Review 
      Manager 5.3. The Cochrane risk of bias tool was used to assess the bias of 
      included studies. The primary outcome was ejection fraction (EF), whereas the 
      secondary outcomes were readmission and mortality rates. Three RCTs (201 
      patients) were included in this meta-analysis. The overall effect did not favor 
      either of the two groups in terms of risk of readmission (risk ratio = 0.5, 95% 
      confidence interval (CI) = 0.22-1.15, p = 0.10) as well as mortality rate (risk 
      ratio = 0.44, 95% CI = 0.14-1.44, p = 0.18). However, there was an improvement in 
      EF in patients who received HUC-MSCs compared to placebo after 12 months of 
      transplantation (mean difference (MD) = 3.21, 95% CI = 2.91-3.51, p < 0.00001). 
      At the six-month follow-up period, there was no significant improvement in EF (MD 
      = 1.30, 95% CI = -1.94-4.54), p = 0.43), indicating that the duration of 
      follow-up can shape the response to therapy. Our findings indicate that HUC-MSC 
      transplantation can improve EF but has no meaningful effect on readmission or 
      mortality rates. Existing evidence is insufficient to confirm the efficacy of 
      HUC-MSCs for broader therapeutic applications. Therefore, additional double-blind 
      RCTs with larger sample sizes are required.
CI  - Copyright (c) 2023, Abouzid et al.
FAU - Abouzid, Mohamed R
AU  - Abouzid MR
AD  - Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, USA.
FAU - Ali, Karim
AU  - Ali K
AD  - Internal Medicine, Hennepin Healthcare, Minneapolis, USA.
FAU - Kamel, Ibrahim
AU  - Kamel I
AD  - Internal Medicine, Steward Carney Hospital, Boston, USA.
FAU - Esteghamati, Sadaf
AU  - Esteghamati S
AD  - Internal Medicine, University of La Verne, La Verne, USA.
FAU - Saleh, Amr
AU  - Saleh A
AD  - Faculty of Medicine, Mansoura University, Mansoura, EGY.
FAU - Ghanim, Mohammed
AU  - Ghanim M
AD  - Internal Medicine, University Hospital Sharjah, Sharjah, ARE.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231129
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10686683
OTO - NOTNLM
OT  - ejection fraction
OT  - heart failure
OT  - human umbilical cord-derived mesenchymal stromal cells
OT  - meta-analysis
OT  - mortality
OT  - myocardial infarction
OT  - regenerative therapy
OT  - stem cell therapy
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/11/30 18:45
MHDA- 2023/11/30 18:46
PMCR- 2023/11/29
CRDT- 2023/11/30 17:17
PHST- 2023/11/29 00:00 [accepted]
PHST- 2023/11/30 18:46 [medline]
PHST- 2023/11/30 18:45 [pubmed]
PHST- 2023/11/30 17:17 [entrez]
PHST- 2023/11/29 00:00 [pmc-release]
AID - 10.7759/cureus.49645 [doi]
PST - epublish
SO  - Cureus. 2023 Nov 29;15(11):e49645. doi: 10.7759/cureus.49645. eCollection 2023 
      Nov.