The Safety and Efficacy of Cardiac Stem Cell Therapy for Cardiovascular Disease: A Meta-Analysis of Randomized Controlled Trials.

Abstract

A multitude of studies have investigated the identification of unique antigens and genetic traits associated with cardiac stem cells (CSCs) since their discovery. This meta-analysis aims to assess the safety and efficacy of cardiac stem cells (CSCs), elucidate existing knowledge regarding their potential applications, and compare them with other novel therapeutic strategies for cardiac repair, including bone marrow cells (BMCs) and mesenchymal stem cells (MSCs). Researchers conducted a search of important indexing databases, including PubMed, Scopus, Cochrane Central, Web of Science (WOS), CINAHL, and Embase, to identify pertinent papers published from 1980 to January 2025. A total of 74 studies involving 5,420 participants were selected from 459 evaluated for the study. A total of 2,931 participants were allocated to the intervention group, whereas 2,489 were assigned to the placebo or control groups. The research encompassed 49 papers on BMC therapy, 17 on MSC therapy, five on CSC therapy, and three on ADRC therapy. A 0.4% enhancement in left ventricular ejection fraction (LVEF) [95% confidence interval (95% CI): 0.23-0.57; I2: 85%, P < 0.00001] was noted after stem cell therapy and in the stem cell therapy cohort, left ventricular end-systolic volume (LVESV) diminished by -0.33 mL (95% CI: -0.47 to -0.19; I2: 73%, P < 0.00001), whereas left ventricular end-diastolic volume (LVEDV) reduced by -0.18 mL (95% CI: -0.31 to -0.05; I2: 68%, P = 0.006). Furthermore, in this cohort, the six-minute walk test (6MWT) exhibited an increase of 0.2% (95% CI: 0.06-0.34; I2: 0%, P = 0.005), whereas the standardized mean difference of infarct size (IS) demonstrated a reduction of -0.36% (95% CI: -0.60 to -0.12; I2: 68%; P = 0.004). These findings augment the existing evidence and underscore the transformative potential of stem cell therapy in cardiac treatment.