Author + information
- Muhammad Shahreyara,b,
- Mohamed Morsya,b,
- Mark Hecklea,b,
- Abdul Rashida,b,
- Kodangudi Ramanathana,b,
- Kelly Rogersa,b and
- Rahman Shaha,b
Background: A substantial proportion of patients with coronary artery disease do not achieve complete revascularization and continue to experience refractory angina in spite of optimal medical therapy (OMT). Recently, stem cell therapy has emerged as a potential therapeutic option for these patients. However, individual trials have been criticized for small sample size and lack of statistical power. A moderately-sized RCT has recently been reported. Therefore, we conducted an updated comprehensive meta-analysis of available RCTs.
Methods: Relevant RCTs were included in random-effects models. Risk ratios (RRs) were calculated for dichotomous variables. For continuous variables, the mean difference (MD) between groups was calculated.
Results: Data from 10 RCTs were included. Stem cell therapy decreased Canadian Cardiovascular Society angina class (MD = − 1.01; 95% CI: −1.66 to −3.04; p = 0.002) and angina episodes (MD = −9.20; 95% CI: −15.30 to −3.09; p = 0.003). It improved left ventricular ejection fraction (MD = 3.4; p < 0.001) and exercise capacity (standardized MD = 0.29; P = 0.006). Finally, it also decreased all-cause mortality (RR, 0.34; 95% CI, 0.17 to 0.65; P = 0.001).
Conclusions: In patients with refractory angina and on OMT, stem cell therapy improves symptoms, exercise capacity, and mortality. These findings need confirmation in a larger, well-powered trial.
Moderated Poster Contributions
Acute and Stable Ischemic Heart Disease Moderated Poster Theater, Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-3:55 p.m.
Session Title: Fixing the Heart One Cell at a Time: The Ongoing Promise of Stem Cells
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1178M-03
- 2017 American College of Cardiology Foundation