Evidence map›Paper›PMID 28031416›Full record

SynthesisCirculation research2017

Route of Delivery Modulates the Efficacy of Mesenchymal Stem Cell Therapy for Myocardial Infarction: A Meta-Analysis of Preclinical Studies and Clinical Trials.

Anthony J Kanelidis, Courtney Premer, Juan Lopez, Wayne Balkan, Joshua M Hare

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Circulation research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
105citing papers in PubMed, 8 pooled it
–field-weighted citation impact
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

105 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors.

Anthony J KanelidisFrom the Interdisciplinary Stem Cell Institute (A.J.K., C.P., W.B., J.M.H.), Department of Molecular and Cellular Pharmacology (C.P.), and Department of Medicine (W.B., J.M.H.), University of Miami Miller School of Medicine, FL; and Florida International University Herbert Wertheim College of Medicine, Miami (J.L.).
Courtney PremerFrom the Interdisciplinary Stem Cell Institute (A.J.K., C.P., W.B., J.M.H.), Department of Molecular and Cellular Pharmacology (C.P.), and Department of Medicine (W.B., J.M.H.), University of Miami Miller School of Medicine, FL; and Florida International University Herbert Wertheim College of Medicine, Miami (J.L.).
Juan LopezFrom the Interdisciplinary Stem Cell Institute (A.J.K., C.P., W.B., J.M.H.), Department of Molecular and Cellular Pharmacology (C.P.), and Department of Medicine (W.B., J.M.H.), University of Miami Miller School of Medicine, FL; and Florida International University Herbert Wertheim College of Medicine, Miami (J.L.).
Wayne BalkanFrom the Interdisciplinary Stem Cell Institute (A.J.K., C.P., W.B., J.M.H.), Department of Molecular and Cellular Pharmacology (C.P.), and Department of Medicine (W.B., J.M.H.), University of Miami Miller School of Medicine, FL; and Florida International University Herbert Wertheim College of Medicine, Miami (J.L.).
Joshua M HareFrom the Interdisciplinary Stem Cell Institute (A.J.K., C.P., W.B., J.M.H.), Department of Molecular and Cellular Pharmacology (C.P.), and Department of Medicine (W.B., J.M.H.), University of Miami Miller School of Medicine, FL; and Florida International University Herbert Wertheim College of Medicine, Miami (J.L.). jhare@med.miami.edu.

Funding

Cardioprotective Effect of Growth Hormone Releasing HormoneR01HL107110 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI HARE, JOSHUA M · 2011 to 2020
$5.9M
Cell Based Therapy for Non-Ischemic Dilated CardiomyopathyUM1HL113460 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI HARE, JOSHUA M · 2012 to 2018
$4.3M
Cellular Cardiomyoplasty for Chronic Heart FailureR01HL084275 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI HARE, JOSHUA M · 2007 to 2016
$3.8M
Stem Cells for Dilated CardiomyopathyR01HL110737 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI HARE, JOSHUA M · 2011 to 2015
$3.2M
Nitric Oxide and sex differences in cardiac repairR01HL137355 · NHLBI · UNIVERSITY OF MIAMI SCHOOL OF MEDICINE · PI HARE, JOSHUA M · 2017 to 2020
$1.6M
NHLBI NIH HHS R01 HL084275NHLBI NIH HHS R01 HL107110NHLBI NIH HHS R01 HL110737NHLBI NIH HHS R01 HL137355NHLBI NIH HHS UM1 HL113460
6 · The paper itself

Abstract

rationaleAccumulating data support a therapeutic role for mesenchymal stem cell (MSC) therapy; however, there is no consensus on the optimal route of delivery.

objectiveWe tested the hypothesis that the route of MSC delivery influences the reduction in infarct size and improvement in left ventricular ejection fraction (LVEF). METHODS AND

resultsWe performed a meta-analysis investigating the effect of MSC therapy in acute myocardial infarction (AMI) and chronic ischemic cardiomyopathy preclinical studies (58 studies; n=1165 mouse, rat, swine) which revealed a reduction in infarct size and improvement of LVEF in all animal models. Route of delivery was analyzed in AMI swine studies and clinical trials (6 clinical trials; n=334 patients). In AMI swine studies, transendocardial stem cell injection reduced infarct size (n=49, 9.4% reduction; 95% confidence interval, -15.9 to -3.0), whereas direct intramyocardial injection, intravenous infusion, and intracoronary infusion indicated no improvement. Similarly, transendocardial stem cell injection improved LVEF (n=65, 9.1% increase; 95% confidence interval, 3.7 to 14.5), as did direct intramyocardial injection and intravenous infusion, whereas intracoronary infusion demonstrated no improvement. In humans, changes of LVEF paralleled these results, with transendocardial stem cell injection improving LVEF (n=46, 7.0% increase; 95% confidence interval, 2.7 to 11.3), as did intravenous infusion, but again intracoronary infusion demonstrating no improvement.

conclusionsMSC therapy improves cardiac function in animal models of both AMI and chronic ischemic cardiomyopathy. The route of delivery seems to play a role in modulating the efficacy of MSC therapy in AMI swine studies and clinical trials, suggesting the superiority of transendocardial stem cell injection because of its reduction in infarct size and improvement of LVEF, which has important implications for the design of future studies.

Indexed as

AnimalsClinical Trials as TopicHumansInjectionsMesenchymal Stem Cell TransplantationMiceMyocardial InfarctionRatsSwinecell- and tissue-based therapyheart failuremesenchymal stem cell transplantationmeta-analysismyocardial infarction

Identifiers

PMID28031416
PMCPMC5656247

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Registered trials

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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.