Details

Autor(en) / Beteiligte

• Sürder, Daniel
• Manka, Robert
• Lo Cicero, Viviana
• Moccetti, Tiziano
• Rufibach, Kaspar
• Soncin, Sabrina
• Turchetto, Lucia
• Radrizzani, Marina
• Astori, Giuseppe
• Schwitter, Juerg
• Erne, Paul
• Zuber, Michel
• Auf der Maur, Christoph
• Jamshidi, Peiman
• Gaemperli, Oliver
• Windecker, Stephan
• Moschovitis, Aris
• Wahl, Andreas
• Bühler, Ines
• Wyss, Christophe
• Kozerke, Sebastian
• Landmesser, Ulf
• Lüscher, Thomas F
• Corti, Roberto

Titel

Intracoronary Injection of Bone Marrow–Derived Mononuclear Cells Early or Late After Acute Myocardial Infarction: Effects on Global Left Ventricular Function

Ist Teil von

• Circulation (New York, N.Y.), 2013-05, Vol.127 (19), p.1968-1979

Ort / Verlag

Hagerstown, MD: American Heart Association, Inc

Erscheinungsjahr

2013

Quelle

Electronic Journals Library

Beschreibungen/Notizen

• BACKGROUND—Intracoronary administration of autologous bone marrow–derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction. The optimal time point of administration of BM-MNC is still uncertain and has rarely been addressed prospectively in randomized clinical trials. METHODS AND RESULTS—In a multicenter study, we randomized 200 patients with large, successfully reperfused ST-segment elevation myocardial infarction in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were administered either early (ie, 5 to 7 days) or late (ie, 3 to 4 weeks) after acute myocardial infarction. Cardiac magnetic resonance imaging was performed at baseline and after 4 months. The primary end point was the change from baseline to 4 months in global LV ejection fraction between the 2 treatment groups and the control group. The absolute change in LV ejection fraction from baseline to 4 months was −0.4±8.8% (mean±SD; P=0.74 versus baseline) in the control group, 1.8±8.4% (P=0.12 versus baseline) in the early group, and 0.8±7.6% (P=0.45 versus baseline) in the late group. The treatment effect of BM-MNC as estimated by ANCOVA was 1.25 (95% confidence interval, −1.83 to 4.32; P=0.42) for the early therapy group and 0.55 (95% confidence interval, −2.61 to 3.71; P=0.73) for the late therapy group. CONCLUSIONS—Among patients with ST-segment elevation myocardial infarction and LV dysfunction after successful reperfusion, intracoronary infusion of BM-MNC at either 5 to 7 days or 3 to 4 weeks after acute myocardial infarction did not improve LV function at 4-month follow-up. CLINICAL TRIAL REGISTRATION—URLhttp://www.clinicaltrials.gov. Unique identifierNCT00355186.