Mesenchymal stem cell therapy for heart failure: a meta-analysis; [Therapie mit mesenchymalen Stammzellen bei Herzinsuffizienz: eine Metaanalyse]

Background: Mesenchymal stem cell (MSC) treatment has emerged as an important adjunct therapy for heart failure. However, the use of MSC to treat heart failure has not been well established. We conducted a systematic review and meta-analysis to evaluate the efficacy of MSC treatment for heart failure. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched. Randomized controlled trials (RCTs) assessing the influence of MSC treatment on cardiac function in heart failure were included in this analysis. Two investigators independently searched the articles, extracted data, and assessed the quality of the included studies. Meta-analysis was performed using the fixed-effect model or random-effect model when appropriate. Results: Six RCTs involving 625 patients were included in the meta-analysis. Compared with control interventions in heart failure patients, MSC treatment had no significant influence on cardiovascular death (RR = 0.76; 95% CI = 0.38–1.52; p = 0.43); however, it was associated with significantly increased left ventricular ejection fraction (LVEF; mean = 9.64; 95% CI = 7.56–11.71; p < 0.00001) and reduced rehospitalization rate (RR = 0.41; 95% CI = 0.23–0.73; p = 0.003). In addition, no significant difference between the two groups was observed for the incidence of myocardial infarction (RR = 0.72; 95% CI = 0.10–5.02; p = 0.74), the recurrence of heart failure (RR = 0.88; 95% CI = 0.28–2.81; p = 0.83), and total death (RR = 0.68; 95% CI = 0.37–1.25; p = 0.21). Conclusion: Although MSC treatment can significantly improve LVEF and reduce rehospitalization rates, it does not have a significant influence on cardiovascular death, myocardial infarction, heart failure, and total death. © 2018, Springer Medizin Verlag GmbH, ein Teil von Springer Nature.