Cardiovascular diseases (CVDs), including myocardial infarction (MI) and heart failure (HF), remain major contributors to global morbidity and mortality despite advances in therapy. Stem cell therapy (SCT) has been proposed as an adjunctive strategy in patients with ischemic heart disease (IHD) and HF.

A systematic review and meta-analysis published in Systematic Reviews evaluated the efficacy and safety of SCT in patients with IHD and HF. Literature searches across PubMed, Web of Science, Embase, Scopus, and Science Direct identified randomized controlled trials (RCTs) enrolling patients with MI or HF. 

Primary outcomes included changes in left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), infarct size, functional status, and quality of life, with safety assessed using risk ratios. Subgroup analyses examined follow-up duration, delivery method, and stem cell type.

A total of 35 RCTs involving 3,345 patients (1,875 SCT; 1,488 control) were included. SCT was associated with higher LVEF at 3, 6, and 12 months (mean difference [MD] 1.43; 95% confidence interval [CI] 0.92–1.95; p<0.00001). Reductions in LVEDV (MD −5.23; 95% CI −7.55 to −2.91; p<0.0001) and LVESV (MD −6.91; 95% CI −9.01 to −4.82; p<0.00001) were observed. Infarct size decreased significantly at 6 and 12 months. Improvements in functional status and quality of life were reported. SCT was reported to be well tolerated.

SCT was associated with modest changes in cardiac function and ventricular volumes and was reported to be well tolerated. Further studies are required to standardize treatment approaches and evaluate long-term outcomes.