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Intramyocardial autologous CD34+ cell therapy for refractory angina: A meta-analysis of randomized controlled trials.
- Source :
-
Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2019 Mar; Vol. 20 (3), pp. 215-219. Date of Electronic Publication: 2018 Jun 05. - Publication Year :
- 2019
-
Abstract
- Background: Previous studies have demonstrated that intramyocardial human CD34+ cells may relieve symptoms and improve clinical outcomes in chronic refractory angina unresponsive to optimal medical therapy or not amenable to revascularization.<br />Methods: We performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the impact of human CD34+ cells compared with placebo in chronic refractory angina. Primary efficacy outcomes in our analysis were angina frequency and exercise time. Primary safety outcomes included major adverse cardiovascular events such as myocardial infarction (MI), stroke and death.<br />Results: Three eligible randomized trials including 269 patients (placebo = 90, CD34+ = 179) were included. Dose of auto-CD34+ cells ranged from 5 × 10 <superscript>4</superscript> to 5 × 10 <superscript>5</superscript> cells/kg. Follow-up ranged from 6 to 24 months. In a pooled analysis, administration of CD34+ cells decreased the risk of all-cause mortality [OR 0.24, 95% CI (0.08-0.73), p = 0.01], reduced angina frequency [mean difference -2.91, 95% CI (-4.57 to -1.25), p = 0.0006] and improved exercise time [mean difference 58.62 s, 95% CI (21.19 to 96.06), p = 0.02] compared with control group. However, there was no significant difference in the risk of myocardial infarction (MI) and stroke between groups.<br />Conclusion: In a meta-analysis, intra-myocardial CD34+ cell therapy was superior to placebo in improving risk of all - cause mortality, angina frequency with an increase in exercise time, without a significant increase in adverse events. This analysis supports further trials of CD34+ cell therapy for ischemic heart disease.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Angina Pectoris metabolism
Angina Pectoris mortality
Angina Pectoris physiopathology
Exercise Tolerance
Health Status
Humans
Randomized Controlled Trials as Topic
Recovery of Function
Risk Factors
Time Factors
Transplantation, Autologous
Treatment Outcome
Angina Pectoris surgery
Antigens, CD34 metabolism
Neovascularization, Physiologic
Stem Cell Transplantation adverse effects
Stem Cell Transplantation mortality
Stem Cells metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1878-0938
- Volume :
- 20
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Cardiovascular revascularization medicine : including molecular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 29908826
- Full Text :
- https://doi.org/10.1016/j.carrev.2018.05.018