Injectable Hydrogel-Based Combination Therapy for Myocardial Infarction: A Systematic Review and Meta-Analysis of Preclinical Trials

Introduction: This study evaluates the efficacy of a combined regimen based on injectable hydrogels for the treatment of experimental myocardial infarction. Patient concerns: Myocardial infarction is an acute illness associated with a decline in quality of life and increased mortality. Experimental myocardial infarction models can facilitate disease research for developing therapies that effectively manage disease progression and promote tissue repair. Diagnosis: An experimental myocardial infarction animal model was established using the ligation method of the anterior descending branch of the left coronary artery (LAD). Interventions: The efficacy of combining hydrogels with various therapies for intramyocardial injection was assessed to evaluate the functional and morphological improvements in the post-infarction heart achieved through the combined hydrogel regimen. Outcomes: The literature review spanned PubMed, Web of Science, Scopus, and Cochrane databases. A total of 83 papers were included in the meta-analysis according to the inclusion and exclusion criteria. When analyzing a murine small animal model, the combination therapy group using hydrogel showed a significant improvement in the primary outcome of left ventricular ejection fraction, with an overall effect size of 11.68 (95% confidence interval (CI): 10.24,13.12) compared to the group receiving hydrogel injection alone. The overall effect size for short-axis shortening was 6.25 (95% CI: 5.98,6.52). Subgroup analysis suggested that the source of hydrogel had a minor impact on the treatment outcome. Conclusion: The present study demonstrated that combining hydrogel with other therapies effectively treated myocardial infarction, improving heart function and morphology. More research and clinical trials should be conducted using large animal models for further study and validation.