Evidence map›Paper›PMID 26160853›Full record

SynthesisCirculation research2015

Adult Bone Marrow Cell Therapy for Ischemic Heart Disease: Evidence and Insights From Randomized Controlled Trials.

Muhammad R Afzal, Anweshan Samanta, Zubair I Shah, Vinodh Jeevanantham, Ahmed Abdel-Latif, Ewa K Zuba-Surma, Buddhadeb Dawn

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Circulation research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 6 pooled it
18.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 6 syntheses or guidelines pooled it, 210 citations in OpenAlex.

  1. Pooled it
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  6. Stem cell treatment for acute myocardial infarction.The Cochrane database of systematic reviews · 2015
    Pooled it
  7. Trial
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  11. Article
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  19. Stem Cell Therapy against Ischemic Heart Disease.International journal of molecular sciences · 2024
    Review
  20. To Repair a Broken Heart: Stem Cells in Ischemic Heart Disease.Current issues in molecular biology · 2024
    Review

50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Muhammad R AfzalFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Anweshan SamantaFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Zubair I ShahFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Vinodh JeevananthamFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Ahmed Abdel-LatifFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Ewa K Zuba-SurmaFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S).
Buddhadeb DawnFrom the Division of Cardiovascular Diseases, Cardiovascular Research Institute, and the Midwest Stem Cell Therapy Center, University of Kansas Medical Center, Kansas City (M.R.A., A.S., Z.I.S., B.D.); Heart and Vascular Specialists of Oklahoma, Oklahoma City (V.J.); Division of Cardiology, University of Kentucky, Lexington (A.A.-L.); and Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Krakow, Poland (E.K.Z.-S). bdawn@kumc.edu.
University of Kentucky · US

Funding

The role of IKKß in linking obesity to adipose tissue inflammation and adipogeneP20GM103527 · NIGMS · UNIVERSITY OF KENTUCKY · PI CASSIS, LISA A · 2012 to 2017
$13.7M
Infarct Repair with Mesenchymal Stem Cell SubpopulationR01HL117730 · NHLBI · UNIVERSITY OF NEVADA LAS VEGAS · PI DAWN, BUDDHADEB · 2013 to 2017
$1.9M
NHLBI NIH HHS R01 HL-117730NHLBI NIH HHS R01 HL117730NIGMS NIH HHS P20 GM103527
6 · The paper itself

Abstract

rationaleNotwithstanding the uncertainties about the outcomes of bone marrow cell (BMC) therapy for heart repair, further insights are critically needed to improve this promising approach.

objectiveTo delineate the true effect of BMC therapy for cardiac repair and gain insights for future trials through systematic review and meta-analysis of data from eligible randomized controlled trials. METHODS AND

resultsDatabase searches through August 2014 identified 48 eligible randomized controlled trials (enrolling 2602 patients). Weighted mean differences for changes in left ventricular (LV) ejection fraction, infarct size, LV end-systolic volume, and LV end-diastolic volume were analyzed with random-effects meta-analysis. Compared with standard therapy, BMC transplantation improved LV ejection fraction (2.92%; 95% confidence interval, 1.91-3.92; P<0.00001), reduced infarct size (-2.25%; 95% confidence interval, -3.55 to -0.95; P=0.0007) and LV end-systolic volume (-6.37 mL; 95% confidence interval, -8.95 to -3.80; P<0.00001), and tended to reduce LV end-diastolic volume (-2.26 mL; 95% confidence interval, -4.59 to 0.07; P=0.06). Similar effects were noted when data were analyzed after excluding studies with discrepancies in reporting of outcomes. The benefits also persisted when cardiac catheterization was performed in control patients as well. Although imaging modalities partly influenced the outcomes, LV ejection fraction improved in BMC-treated patients when assessed by magnetic resonance imaging. Early (<48 hours) BMC injection after myocardial Infarction was more effective in reducing infarct size, whereas BMC injection between 3 and 10 days proved superior toward improving systolic function. A minimum of 50 million BMCs seemed to be necessary, with limited additional benefits seen with increasing cell numbers. BMC therapy was safe and improved clinical outcomes, including all-cause mortality, recurrent myocardial Infarction, ventricular arrhythmia, and cerebrovascular accident during follow-up, albeit with differences between acute myocardial Infarction and chronic ischemic heart disease subgroups.

conclusionsTransplantation of adult BMCs improves LV ejection fraction, reduces infarct size, and ameliorates remodeling in patients with ischemic heart disease. These effects are upheld in the analyses of studies using magnetic resonance imaging and also after excluding studies with discrepant reporting of outcomes. BMC transplantation may also reduce the incidence of death, recurrent myocardial Infarction, ventricular arrhythmia, and cerebrovascular accident during follow-up.

Indexed as

AdultBone Marrow TransplantationEvidence-Based MedicineHumansMyocardial IschemiaRandomized Controlled Trials as Topicbone marrow mononuclear cellsmeta-analysismyocardial infarctionmyocardial ischemiastem cells

Identifiers

PMID26160853
PMCPMC4553075
OpenAlexW2751661738

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.