BMC Cardiovasc Disord. 2025 Jul 5;25(1):486. doi: 10.1186/s12872-025-04938-8.
ABSTRACT
BACKGROUND: Over the past decade, there has been no clear evidence regarding the comparative effectiveness of bone-marrow mononuclear cell (BMMNC) therapy in patients with chronic heart failure (HF).
METHODS: We retrieved eligible randomized controlled trials (RCTs) of bone marrow mononuclear cells (BMMNCs) in patients with heart failure (HF) using a systematic approach of PRISMA guideline and focusing on studies published between 2015 and 2025. We performed a meta-analysis on clinical outcomes, including major adverse cardiovascular events (MACE), hospitalization for HF, and mortality, as well as echocardiographic indices, such as left ventricular ejection fraction (LVEF). The analysis was conducted using a random-effects model. Risk ratios (RR) or mean differences (MD) with corresponding 95% confidence intervals (CI) were pooled based on the type of outcome.
RESULTS: The analysis pooled data from 379 patients from 7 RCT studies, including 189 patients experienced BM-MNC and 190 patients in control group. While the stem cell group showed a slight improvement in left ventricular ejection fraction (LVEF) [MD=-0.73, 95%Cl (-2.14,0.68), P = 0.31] at both 3 months [MD = 2.34, 95%Cl (-1.94,6.62), P = 0.28] and 1 year [MD = 1.69, 95%Cl (-2.29,5.66), P = 0.41] compared to controls, these differences did not reach statistical significance (P > 0.05). Furthermore, stem cell therapy demonstrated no significant benefits in reducing morbidity [RR = 0.99, 95%Cl (0.40, 2.49), P = 0.99], mortality [RR = 1.55, 95%Cl (0.50,4.85), P = 0.45], rehospitalization rates [RR = 1.09, 95%Cl (0.63,1.88) P = 0.75], or major adverse cardiac events (MACE) [RR = 0.59, 95%CI (0.14, 2.46), P = 0.47], as well as injection route used (P > 0.05 for all outcomes).
CONCLUSION: The analysis of 7 RCTs found no statistically significant benefits of stem cell therapy on LVEF, clinical outcomes, or MACE, regardless of injection route. Current evidence does not support its routine use; further research is warranted.
PMID:40618035 | DOI:10.1186/s12872-025-04938-8