Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0151744 (myocardial ischemia)
31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Preclinical and clinical evidence suggests that mesenchymal stem cells (MSCs) may be beneficial in treating both acute myocardial infarction (AMI) and ischemic heart failure (IHF). However, the safety profile and efficacy of MSC therapy is not well-known. We conducted a systematic review of clinical trials that evaluated the safety or efficacy of MSCs for AMI or IHF. Embase, PubMed/Medline, and Cochrane Central Register of Controlled Trials were searched from inception to September 27, 2017. Studies that examined the use of MSCs administered to adults with AMI or IHF were eligible. The Cochrane risk of bias tool was used to assess bias of included studies. The primary outcome was safety assessed by adverse events and the secondary outcome was efficacy which was assessed by mortality and left ventricular ejection fraction (LVEF). A total of 668 citations were reviewed and 23 studies met eligibility criteria. Of these, 11 studies evaluated AMI and 12 studies evaluated IHF. There was no association between MSCs and acute adverse events. There was a significant improvement in overall LVEF in patients who received MSCs (SMD 0.73, 95% CI 0.24-1.21). No significant difference in mortality was noted (Peto OR 0.68, 95% CI 0.38-1.22). Results from our systematic review suggest that MSC therapy for ischemic heart disease appears to be safe. There is a need for a well-designed adequately powered randomized control trial (with rigorous adverse event reporting and evaluations of cardiac function) to further establish a clear risk-benefit profile of MSCs. Stem Cells Translational Medicine 2018;7:857-866.
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PMID:Safety and Efficacy of Adult Stem Cell Therapy for Acute Myocardial Infarction and Ischemic Heart Failure (SafeCell Heart): A Systematic Review and Meta-Analysis. 3025 89

Objective To explore the therapeutic effects of trimetazidine (TMZ) on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed, EMBASE, and Cochrane databases between the inception dates of databases and May 2019 (last search conducted on 30 May 2019) to identify randomized controlled trials. The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment. Random or fixed models were used to investigate pooled mean differences in left ventricular function, serum glucose metabolism, serum lipid profile, myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95% confidence interval (CI).Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction (WMD=4.39, 95%CI: 3.83, 4.95, P<0.00001), left ventricular end diastolic diameter (WMD=-3.17, 95%CI: -4.90, -1.44, P=0.0003) and left ventricular end systolic diameter (WMD=-4.69, 95%CI: -8.66, -0.72, P=0.02). TMZ administration also significantly decreased fasting blood glucose (SMD=-0.43, 95%CI: -0.70, -0.17, P=0.001), glycosylated hemoglobin level (WMD=-0.59, 95%CI: -0.95, -0.24, P=0.001), serum level of total cholesterol (WMD=-20.36, 95%CI: -39.80, -0.92, P=0.04), low-density lipoprotein cholesterol (WMD=-20.12, 95%CI: -32.95, -7.30, P=0.002) and incidence of myocardial ischemia episodes (SMD=-0.84, 95%CI: -1.50, -0.18, P=0.01). However, there were no significant differences in serum triglyceride level, high-density lipoprotein cholesterol, exercise tolerance between the TMZ group and the control group. Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function, serum glucose and lipid metabolism and clinical symptoms.
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PMID:Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials. 3297