Article type
Year
Abstract
Background:
Stem cell transplantation has provided a new therapeutic strategy for myocardial infarction (MI). However, its efficacy and safety were still conflicting and uncertain. Moreover, the quality of existing evidence was unknown.
Objectives:
To summarize and critically evaluate the quality of the evidence from systematic reviews (SRs) and meta-analyses assessing the efficacy and safety of stem cell therapy for MI.
Methods:
An electronic search was performed in Web of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database and SinoMed from inception to June 2019. The methodological and reporting quality of the included reviews was assessed by Assessment of Multiple Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), respectively. And the quality of the evidence was rated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE).
Results:
Thirty-seven SRs were included. The results suggest that stem cell transplantation has beneficial effects for patients with MI, especially in improving left ventricular ejection fraction (LVEF) and left ventricular end-systolic volumes (LVESV). And it is safe without increasing the risk of major adverse clinical events. However, there was inconclusive evidence that stem cell therapy had significant effects on left ventricular end-diastolic volumes (LVEDV) and infarct size. According to AMSTAR, only two of these 37 studies satisfied all the items and the coincidence of“Yes”for each of the 11 items ranged from 5.41% to 100%. Among the 27 items of PRISMA, none of the included SRs fulfilled all 27 items, and the score of reporting quality ranged from 12.5 to 26, with an average of 21.5. Most of the evidence was rated as “moderate quality” or “low quality” by GRADE, mainly because of poor quality of primary trials, publication bias and inconsistency.
Conclusions:
Stem cell transplantation generally appears to be effective and safe for patients with MI. However, the reporting and methodological quality of systematic reviews and meta-analyses were suboptimal, which demands improvement. More high-quality evidence is needed to further determine the efficacy and safety of stem cell therapy.
Patient or healthcare consumer involvement:
No
Stem cell transplantation has provided a new therapeutic strategy for myocardial infarction (MI). However, its efficacy and safety were still conflicting and uncertain. Moreover, the quality of existing evidence was unknown.
Objectives:
To summarize and critically evaluate the quality of the evidence from systematic reviews (SRs) and meta-analyses assessing the efficacy and safety of stem cell therapy for MI.
Methods:
An electronic search was performed in Web of Science, PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Database and SinoMed from inception to June 2019. The methodological and reporting quality of the included reviews was assessed by Assessment of Multiple Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), respectively. And the quality of the evidence was rated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE).
Results:
Thirty-seven SRs were included. The results suggest that stem cell transplantation has beneficial effects for patients with MI, especially in improving left ventricular ejection fraction (LVEF) and left ventricular end-systolic volumes (LVESV). And it is safe without increasing the risk of major adverse clinical events. However, there was inconclusive evidence that stem cell therapy had significant effects on left ventricular end-diastolic volumes (LVEDV) and infarct size. According to AMSTAR, only two of these 37 studies satisfied all the items and the coincidence of“Yes”for each of the 11 items ranged from 5.41% to 100%. Among the 27 items of PRISMA, none of the included SRs fulfilled all 27 items, and the score of reporting quality ranged from 12.5 to 26, with an average of 21.5. Most of the evidence was rated as “moderate quality” or “low quality” by GRADE, mainly because of poor quality of primary trials, publication bias and inconsistency.
Conclusions:
Stem cell transplantation generally appears to be effective and safe for patients with MI. However, the reporting and methodological quality of systematic reviews and meta-analyses were suboptimal, which demands improvement. More high-quality evidence is needed to further determine the efficacy and safety of stem cell therapy.
Patient or healthcare consumer involvement:
No