State of the Art on the Evidence Base in Cardiac Regenerative Therapy: Overview of 41 Systematic Reviews

Authors

Mariangela Peruzzi, Sapienza University of Rome
Elena De Falco, Sapienza University of Rome
Antonio Abbate, Virginia Commonwealth UniversityFollow
Giuseppe Biondi-Zoccai, Sapienza University of Rome, Virginia Commonwealth University, and Fondazione Eleonora Lorillard Spencer Cenci
Isotta Chimenti, Sapienza University of Rome
Marzia Lotrionte, Columbus Integrated Complex
Umberto Benedetto, Oxford University Hospital
Ronak Delewi, Academic Medical Center Amsterdam
Antonino G. M. Marullo, Sapienza University of Rome
Giacomo Frati, Sapienza University of Rome, and IRCCS Neuromed

Document Type

Article

Original Publication Date

2015

Journal/Book/Conference Title

BioMed Research International

Volume

2015

Issue

2015

DOI of Original Publication

10.1155/2015/613782

Comments

Originally published at https://www.hindawi.com/journals/bmri/2015/613782/.

Date of Submission

October 2016

Abstract

Objectives. To provide a comprehensive appraisal of the evidence from secondary research on cardiac regenerative therapy. Study Design and Setting. Overview of systematic reviews of controlled clinical trials concerning stem cell administration or mobilization in patients with cardiovascular disease. Results. After a systematic database search, we short-listed 41 reviews (660 patients). Twenty-two (54%) reviews focused on acute myocardial infarction (AMI), 19 (46%) on chronic ischemic heart disease (IHD) or heart failure (HF), 29 (71%) on bone marrow-derived stem-cells (BMSC), and 36 (88%) to randomized trials only. Substantial variability among reviews was found for validity (AMSTAR score: median 9 [minimum 3]; 1st quartile 9; 3rd quartile 10; maximum 11), effect estimates (change in ejection fraction from baseline to follow-up: 3.47% [0.02%; 2.90%; 4.22%; 6.11%]), and citations (Web of Science yearly citations: 4.1 [0; 2.2; 6.5; 68.9]). No significant association was found between these three features. However, reviews focusing on BMSC therapy had higher validity scores (P = 0.008) and showed more pronounced effect estimates (P = 0.002). Higher citations were associated with journal impact factor (P = 0.007), corresponding author from North America/Europe (P = 0.022), and inclusion of nonrandomized trials (P = 0.046). Conclusions. Substantial heterogeneity is apparent among these reviews in terms of quality and effect estimates.

Rights

Copyright © 2015 Mariangela Peruzzi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Is Part Of

VCU Internal Medicine Publications