Effects Of Timing On Intracoronary Autologous Bone Marrow Stem Cells Transplantation In Acute Myocardial Infarction： A Meta-analysis For Randomized Controlled Trials

Objective: We conducted a meta-analysis for randomized controlled trials toinvestigate the effects of timing on BMSC therapy in Acute Myocardial Infarction (AMI).Methods: A systematic literature search of PubMed, Ovid’s MEDLINE, andCochrane Evidence-Based Medicine databases from Jan.2000to June2011wasdesigned for randomized controlled trials with at least3-month follow-up in whichpatients were all with AMI undergoing emergent percutaneous coronary intervention(PCI) and whereafter receiving intracoronary BMSC transplantation. The data wereanalyzed for evaluating the effects of timing on BMSC therapy in AMI.Results: A total of9randomized controlled trials with700patients were eligiblefor the Meta-analysis. It showed the mean increase in left ventricular ejection fraction(LVEF) from the baseline was2.38%(P=0.04）in BMSC transplantation within24hours group and the effect on either left ventricular end-diastolic dimensions or leftventricular end-systolic dimensions was no statistically significant difference. But at3to7days post-AMI the change in LVEF was2.84%（P=0.0002）and the decreaseshowed in LV end-systolic dimensions and LV end-diastolic dimensions wassignificant(SMD=-0.32，95%CI：-0.54，-0.1；P=0.005)(SMD=-0.23，95%CI：-0.46，0.0；P=0.05).Meanwhile,in the subgroup analysis LVEF was significantly increased inthe patients with lower baseline LVEF<50%(WMD=3.62%，95%CI：0.41%，6.83%，P=0.03)， as well as patients with dose of108cells (WMD=3.12%，95%CI：1.09%,5.15%，P=0.003).Conclusions: The BMSC transplantation at3to7days post-AMI was superior to whichwithin24hours in improving LVEF or decreasing LV end-systolic dimensions or LVend-diastolic dimensions. It is more effective in patients with lower baseline LVEF or dose of108cells.