Table of Contents
ISRN Stem Cells
Volume 2014 (2014), Article ID 293967, 13 pages
http://dx.doi.org/10.1155/2014/293967
Review Article

Total Ischemic Time as an Independent Predictor of Response to Stem Cell Therapy in Patients with ST Segment Elevation Myocardial Infarction

1Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
2Division of Cardiovascular Medicine, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
3Cardiology Service, Ankara Mevki Military Hospital, 06110 Ankara, Turkey
4Center for Clinical and Translational Sciences, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
5Utah Cardiology PC, Layton, UT 84041, USA

Received 5 November 2013; Accepted 27 November 2013; Published 16 January 2014

Academic Editors: F. Fagioli, U. Galderisi, K. Guan, I. E. Hoefer, and P. P. Young

Copyright © 2014 Mary Lim 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.

Abstract

The selection criteria for bone marrow stem cell (BMSC) therapy are not well established for ST segment elevation myocardial infarction (STEMI) patients. This investigation seeks to utilize total ischemic time (TIT), time of symptom onset to percutaneous coronary intervention (PCI), as a criterion for giving BMSC to STEMI patients. A meta-analysis and metaregression were conducted to evaluate improvement of LVEF with BMSC and its association with TIT (<6 and ≥6 hours) and baseline LVEF (<45% and ≥45%) at short (3–6 months) and long term (>6 months) followup. At short term, BMSC allowed improvement of LVEF with prolonged TIT (6.62%, 95% CI, 2.26 to 10.98 for <45%; 6.13%, 95% CI, 2.59 to 9.67 for ≥45%). Similarly, for long term, receiving BMSC allowed significant improvement of LVEF for prolonged TIT (9.19%, 95% CI, 2.34 to 16.05 for <45%; 7.64%, 95% CI, 3.72 to 11.56 for ≥45%). Additionally, TIT was a significant predictor of LVEF improvement independent of baseline LVEF in both short (4.96%, 95% CI, 0.72 to 9.19, ) and long term (6.24%, 95% CI, 0.46 to 12.02, ) followup. Consequently, BMSC therapy allows LVEF improvement in prolonged TIT and future studies for BMSC should include TIT ≥ 6 hours as an inclusion criterion.