On 2014 Feb 19, Valeria Fadda commented:

Co-authors of this Note: Roberta Gatto, Dario Maratea, Sabrina Trippoli, and Andrea Messori (all from the HTA Unit of Estav in Firenze, Italy).

The studies by Surder et al.[1] and by Traverse et al. [2] are a further improvement to the overall knowledge about the effectiveness of stem cell treatment in ischemic heart disease. Very few experiences are in fact available in the scientific literature about this relatively new therapeutic strategy. Since the systematic review of Clifford et al. [3] represents the most accurate previous attempt to shed light on this intervention for the acute treatment of myocardial infarction, adding the two trials (Surder et al.; Traverse et al.) to Clifford’s meta-analysis can be worthwhile. With reference to the end-point of left ventricular ejection fraction, we incorporated the results of the two trials (Surder et al.; Traverse et al.)into the meta-analysis of Clifford et al. The results of our analysis (Figure 1) show the superiority of treatment with intracoronary bone marrow-derived cells over placebo, thus confirming the results reported by Clifford et al. The main difference is that confidence intervals have become slightly wider after the addition of the two above mentioned trials.

References

1. Surder D, Manka R, Lo Cicero V et al. Intracoronary injection of bone marrow-derived mononuclear cells early or late after acute myocardial infarction: effects on global left ventricular function. Circulation. 2013 May 14;127(19):1968-79. doi: 10.1161/CIRCULATIONAHA.112.001035

2. Traverse JH, Henry TD, Pepine CJ et al. Cardiovascular Cell Therapy Research Network (CCTRN). Effect of the use and timing of bone marrow mononuclear cell delivery on left ventricular function after acute myocardial infarction: the TIME randomized trial. JAMA. 2012 Dec 12;308(22):2380-9. Erratum in: JAMA. 2013 Jan 23;309(4):343. PubMed PMID: 23129008; PubMed Central PMCID: PMC3652242.

3. Clifford DM, Fisher SA, Brunskill SJ et al. Stem cell treatment for acute myocardial infarction. Cochrane Database Syst Rev. 2012 Feb 15;2:CD006536. doi: 10.1002/14651858.CD006536.pub3

Figure 1. Comparison of intracoronary stem cell treatment with no stem cells in patients with acute myocardial infarction: pooled difference in mean change in LVEF from baseline to end of study. This figure is available at: http://www.osservatorioinnovazione.net/papers/Figure_1.jpg

Valeria Fadda HTA Unit Estav Regional Health System 50100 Firenze Italy

On 2014 Feb 19, Valeria Fadda commented:

Co-authors of this Note: Roberta Gatto, Dario Maratea, Sabrina Trippoli, and Andrea Messori (all from the HTA Unit of Estav in Firenze, Italy).

The studies by Surder et al.[1] and by Traverse et al. [2] are a further improvement to the overall knowledge about the effectiveness of stem cell treatment in ischemic heart disease. Very few experiences are in fact available in the scientific literature about this relatively new therapeutic strategy. Since the systematic review of Clifford et al. [3] represents the most accurate previous attempt to shed light on this intervention for the acute treatment of myocardial infarction, adding the two trials (Surder et al.; Traverse et al.) to Clifford’s meta-analysis can be worthwhile. With reference to the end-point of left ventricular ejection fraction, we incorporated the results of the two trials (Surder et al.; Traverse et al.)into the meta-analysis of Clifford et al. The results of our analysis (Figure 1) show the superiority of treatment with intracoronary bone marrow-derived cells over placebo, thus confirming the results reported by Clifford et al. The main difference is that confidence intervals have become slightly wider after the addition of the two above mentioned trials.

References

1. Surder D, Manka R, Lo Cicero V et al. Intracoronary injection of bone marrow-derived mononuclear cells early or late after acute myocardial infarction: effects on global left ventricular function. Circulation. 2013 May 14;127(19):1968-79. doi: 10.1161/CIRCULATIONAHA.112.001035

2. Traverse JH, Henry TD, Pepine CJ et al. Cardiovascular Cell Therapy Research Network (CCTRN). Effect of the use and timing of bone marrow mononuclear cell delivery on left ventricular function after acute myocardial infarction: the TIME randomized trial. JAMA. 2012 Dec 12;308(22):2380-9. Erratum in: JAMA. 2013 Jan 23;309(4):343. PubMed PMID: 23129008; PubMed Central PMCID: PMC3652242.

3. Clifford DM, Fisher SA, Brunskill SJ et al. Stem cell treatment for acute myocardial infarction. Cochrane Database Syst Rev. 2012 Feb 15;2:CD006536. doi: 10.1002/14651858.CD006536.pub3

Figure 1. Comparison of intracoronary stem cell treatment with no stem cells in patients with acute myocardial infarction: pooled difference in mean change in LVEF from baseline to end of study. This figure is available at: http://www.osservatorioinnovazione.net/papers/Figure_1.jpg

Valeria Fadda HTA Unit Estav Regional Health System 50100 Firenze Italy