Meta-analysis of coronary artery bypass graft surgery combined with stem cell transplantation in the treatment of ischemic heart diseases.

ABSTRACT

OBJECTIVE: The use of bone marrow cells (BMCs) to regenerate the myocardium and vessels is a new treatment for ischemic heart diseases (IHD) that has been receiving attention. In this study, a meta-analysis was used to analyze the efficacy of combining coronary artery bypass graft (CABG) surgery with BMC transplantation in the treatment of IHD. METHODS AND RESULTS: MEDLINE, EMBASE, Cochrane, CNKI, WAN-FANG, and WEI-PU databases were searched. The main inclusion criteria were as follows (a) studies that analyzed patients diagnosed with chronic IHD. (b) Studies that had randomized-controlled trials. (c) Studies that included research comparing the efficacy of CABG and CABG combined with bone BMC transplantation in the treatment of IHD. (d) Studies with specific enumeration data at the end of the follow-up with a follow-up time of at least 3 months. Nine randomized trials were included. There were 158 patients in the group that received the treatment of CABG surgery as well as stem cell transplantation, referred to as the 'cell transplantation group.' A total of 147 patients were in the group that only received the treatment of CABG surgery, referred to as the 'CABG group'. Our data show that not only did stem cell transplantation significantly improve left ventricular ejection fraction (odds ratio=11.7, 95% confidence interval 4.04-19.36; P=0.003) but it also significantly reduced the left ventricular end-diastolic volume and left ventricular end-systolic volume (P<0.001). CONCLUSION: BMC transplantation is associated with a significant improvement in left ventricular ejection fraction and the attenuation of left ventricular remodeling.