Efficacy and safety in comparison of mononuclear cell (MNC) or mesenchymal stem cell (MSC) injection in patients with acute myocardial infarction: a network meta-analysis

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Jeong H1, Yim HW1, Oh I1, Kim N2
1College of Medicine, The Catholic University of Korea, 2Medical library, The Catholic University of Korea

Background: clinical evidence has shown that the intracoronary delivery of mononuclear cells (MNCs) or mesenchymal stem cells (MSCs) can improve the ejection fraction and reduce the infarct size in patients with acute myocardial infarction (AMI). Stem cells are introduced using a balloon to temporarily occlude flow and a special catheter injects cells into the infarct-related artery. Intracoronary cell administration obviously seems to be advantageous for tissue repair of infarcted heart muscle by supplying the entire heart muscle compartment. However, safety profiles might be different from the cell type, cellular product size, and characterization of the cell population in intracoronary administration.

Objectives: we conducted a systematic review to compare efficacy and safety profiles in intracoronary injection of MNC to MSC using a network meta-analysis.

Methods: we identified randomized controlled trials in patients with AMI receiving MNC or MSC therapy from PubMed, Embase, and the Cochrane Library from inception to January 2019. We included 41 RCTs in the analysis.

Results and conclusions: using network meta-analysis, we will analyze whether MNC or MSC therapy has a better effect on improvement of left ventricle ejection fraction, and which one is safer in terms of incidence rates of all-cause mortality, revisualization, restenosis serious averse effects and rehospitalization for heart failure.

Acknowledgement: this research was supported by a grant (18172MFDS182) from the Ministry of Food & Drug Safety in 2018.