Long-term effects of autologous bone marrow stem cell treatment in acute myocardial infarction: factors that may influence outcomes.
Long-term effects of autologous bone marrow stem cell treatment in acute myocardial infarction: factors that may influence outcomes.
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DOI：
10.1371/journal.pone.0037373
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Martin-Rendon E
中科院分区：
文献类型：
--
作者：
Clifford DM;Fisher SA;Brunskill SJ;Doree C;Mathur A;Clarke MJ;Watt SM;Martin-Rendon E
目的探讨急性心肌梗死(AMI)自体干细胞治疗的不同临床试验结果之间是否存在重要的异质性来源，并评价哪些因素可能影响该治疗的长期效果。检索Medline(1950-2011年1月)、EMBASE(1974-2011年1月)、CENTAL(Cochrane图书馆2011年第1期)、CINAHL(1982-2011年1月)和正在进行的试验登记，以查找骨髓干细胞治疗急性心肌梗死的随机试验。使用手工搜索来筛选最近的相关会议记录(2005-2010/11)。Meta分析使用随机效应模型，亚组间的异质性使用卡方检验。计划分析包括随访时间、细胞输注时间和剂量、患者选择、小试验规模效应、方法学质量、随访损失和发表日期。共有33项试验，共有1,765名参与者。没有证据表明由于发表或时间滞后、纳入研究的方法学质量、参与者退出、随访持续时间或首次披露结果的日期而产生偏见。然而，在长期的随访中，当剂量超过108个细胞时，这种治疗似乎对更严重的心功能障碍患者更有效。在这项研究中，对试验之间的异质性的评价没有发现显著的偏倚来源。然而，试验之间的临床差异可能存在，在进行未来的试验时应该考虑到这一点。
To investigate whether there are important sources of heterogeneity between the findings of different clinical trials which administer autologous stem cell treatment for acute myocardial infarction (AMI) and to evaluate what factors may influence the long-term effects of this treatment. MEDLINE (1950-January 2011), EMBASE (1974-January 2011), CENTRAL (The Cochrane Library 2011, Issue 1), CINAHL (1982-January 2011), and ongoing trials registers were searched for randomised trials of bone marrow stem cells as treatment for AMI. Hand-searching was used to screen recent, relevant conference proceedings (2005–2010/11). Meta-analyses were conducted using random-effects models and heterogeneity between subgroups was assessed using chi-squared tests. Planned analyses included length of follow-up, timing of cell infusion and dose, patient selection, small trial size effect, methodological quality, loss of follow-up and date of publication. Thirty-three trials with a total of 1,765 participants were included. There was no evidence of bias due to publication or time-lag, methodological quality of included studies, participant drop-out, duration of follow-up or date of the first disclosure of results. However, in long-term follow-ups the treatment seemed more effective when administered at doses greater than 108 cells and to patients with more severe heart dysfunction. Evaluation of heterogeneity between trials has not identified significant sources of bias in this study. However, clinical differences between trials are likely to exist which should be considered when undertaking future trials.
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影响因子：
168.9
作者：
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