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(Circulation. 2005;112:I-178 – I-183.)
© 2005 American Heart Association, Inc.

Cell Transplantation and Tissue Engineering

Intracoronary Injection of CD133-Positive Enriched Bone Marrow Progenitor Cells Promotes Cardiac Recovery After Recent Myocardial Infarction

Feasibility and Safety

Jozef Bartunek, MD, PhD^*; Marc Vanderheyden, MD^*; Bart Vandekerckhove, MD, PhD; Samer Mansour, MD; Bernard De Bruyne, MD, PhD; Pieter De Bondt, MD; Inge Van Haute, MD; Nele Lootens, RN; Guy Heyndrickx, MD, PhD; William Wijns, MD, PhD

From the Cardiovascular Center (J.B., M.V., S.M., B.D.B., G.H., W.W.) and the Department of Nuclear Medicine (P.D.B.), OLV Ziekenhuis, Aalst; Cell Therapy Unit, Flemish Red Cross, Gent (B.V., I.V.H., N.L.); and the University of Gent, Gent (B.V.), Belgium.

Correspondence to Jozef Bartunek, MD, PhD, and Marc Vanderheyden, MD, Cardiovascular Center Aalst, OLV Ziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium. E-mail Jozef.Bartunek{at}olvz-aalst.be or Marc.Vanderheyden@olvz-aalst.be

Background— Bone marrow CD133-postive (CD133⁺) cells possess high hematopoietic and angiogenic capacity. We tested the feasibility, safety, and functional effects of the use of enriched CD133⁺ progenitor cells after intracoronary administration in patients with recent myocardial infarction.

Methods and Results— Among 35 patients with acute myocardial infarction treated with stenting, 19 underwent intracoronary administration of CD133⁺ progenitor cells (12.6±2.2x10⁶ cells) 11.6±1.4 days later (group 1) and 16 did not (group 2). At 4 months, left ventricular ejection fraction increased significantly in group 1 (from 45.0±2.6% to 52.1±3.5%, P<0.05), but only tended to increase in case-matched group 2 patients (from 44.3±3.1% to 48.6±3.6%, P=NS). Likewise, left ventricular regional chordae shortening increased in group 1 (from 11.5±1.0% to 16.1±1.3%, P<0.05) but remained unchanged in group 2 patients (from 11.1±1.1% to 12.7±1.3%, P=NS). This was paralleled by reduction in the perfusion defect in group 1 (from 28.0±4.1% to 22.5±4.1%, P<0.05) and no change in group 2 (from 25.0±3.0% to 22.6±4.1%, P=NS). In group 1, two patients developed in-stent reocclusion, 7 developed in-stent restenosis, and 2 developed significant de novo lesion of the infarct-related artery. In group 2, four patients showed in-stent restenosis. In group 1 patients without reocclusion, glucose uptake shown by positron emission tomography with ¹⁸fluorodeoxyglucose in the infarct-related territory increased from 51.2±2.6% to 57.5±3.5% (P<0.05). No stem cell-related arrhythmias were noted, either clinically or during programmed stimulation studies at 4 months.

Conclusion— In patients with recent myocardial infarction, intracoronary administration of enriched CD133⁺ cells is feasible but was associated with increased incidence of coronary events. Nevertheless, it seems to be associated with improved left ventricular performance paralleled with increased myocardial perfusion and viability.

Key Words: myocardial infarction • cells • restenosis