Impact of mesenchymal stem cell therapy on cardiac function and outcomes in acute myocardial infarction: A meta-analysis of clinical studies.

Abstract

This meta-analysis evaluated the efficacy of mesenchymal stem cell (MSC) treatment on cardiovascular function and major adverse cardiac events (MACE) in patients with acute myocardial infarction (AMI) at various follow-up intervals. Clinical studies comparing MSC therapy with control treatments for AMI were identified from databases including Cochrane, Web of Science, PubMed, Embase, CNKI, and Wanfang, covering publications up to August 2024. Data analysis was conducted using Review Manager 5.4 software. MSC treatment significantly improved left ventricular ejection fraction (LVEF) compared to controls at follow-up intervals <6 months (MD = 3.42; P < 0.0001), 6 months (MD = 4.15; P = 0.006), and 12 months (MD = 2.77; P = 0.006). However, no significant effect on LVEF was observed after 12 months (MD = 3.50; P = 0.17). MSC therapy did not significantly affect left ventricular end-diastolic volume (LVEDV) at any interval. Left ventricular end-systolic volume (LVESV) significantly decreased only within the first 6 months (MD = -11.35; P = 0.11) but not at subsequent follow-ups. Wall motion score index (WMSI) significantly improved at <6 months (MD = -0.06; P < 0.0001), 6 months (MD = -0.04; P = 0.006), and >12 months (MD = -0.03; P = 0.02). However, the improvement at 12 months was borderline significant (MD = -0.06; P = 0.06). MSC therapy showed no significant reduction in MACE (odds ratio [OR] = 1.61; P = 0.10). Subgroup analyses indicated intracoronary MSC administration notably improved LVEF (MD = 4.27; P < 0.0001), while intravenous MSC administration showed no significant effect. Neither administration route significantly affected MACE outcomes. No publication bias was detected. In conclusion, MSC therapy significantly enhances LVEF and WMSI within the first 12 months post-AMI, with intracoronary administration showing greater efficacy than intravenous delivery. However, MSC treatment did not significantly reduce MACE incidence. Further rigorous clinical trials are needed to confirm these findings.