Circulation. 2006;113:1287-1294
Published online before print March 6, 2006, doi: 10.1161/CIRCULATIONAHA.105.575118
Published online before print March 6, 2006, doi: 10.1161/CIRCULATIONAHA.105.575118
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(Circulation. 2006;113:1287-1294.)
© 2006 American Heart Association, Inc.
Coronary Heart Disease |
Intracoronary Bone Marrow Cell Transfer After Myocardial Infarction
Eighteen Months’ Follow-Up Data From the Randomized, Controlled BOOST (BOne marrOw transfer to enhance ST-elevation infarct regeneration) Trial
From the Departments of Cardiology and Angiology (G.P.M., K.C.W., J.S., P.L., S.F., A.S., H.D.), Diagnostic Radiology (J.L.), Biometrics (H.H.), and Hematology and Oncology (L.A., B.H., A.G.), Hannover Medical School, Hannover, Germany.
Correspondence to Prof Dr Helmut Drexler, Abt. Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg Straße 1, 30625 Hannover, Germany. E-mail drexler.helmut{at}mh-hannover.de
Received July 14, 2005; revision received December 15, 2005; accepted January 9, 2006.
Background— Intracoronary transfer of autologous bone marrow cells (BMCs) may enhance recovery of left ventricular (LV) function in patients after acute myocardial infarction (AMI). However, clinical studies addressing the effects of BMCs after AMI have covered only limited time frames ranging from 3 to 6 months. The critical question of whether BMC transfer can have a sustained impact on LV function remains unanswered.
Methods and Results– After percutaneous coronary intervention with stent implantation (PCI) of the infarct-related artery, 60 patients were randomized 1:1 to a control group with optimal postinfarction therapy and a BMC transfer group that also received an intracoronary BMC infusion 4.8±1.3 days after PCI. Cardiac MRI was performed 3.5±1.5 days, 6±1 months, and 18±6 months after PCI. BMC transfer was not associated with adverse clinical events. In the control group, mean global LV ejection fraction increased by 0.7 and 3.1 percentage points after 6 and 18 months, respectively. LV ejection fraction in the BMC transfer group increased by 6.7 and 5.9 percentage points. The difference in LVEF improvement between groups was significant after 6 months but not after 18 months (P=0.27). The speed of LV ejection fraction recovery over the course of 18 months was significantly higher in the BMC transfer group (P=0.001).
Conclusions– In this study, a single dose of intracoronary BMCs did not provide long-term benefit on LV systolic function after AMI compared with a randomized control group; however, the study suggests an acceleration of LV ejection fraction recovery after AMI by BMC therapy.
CLINICAL PERSPECTIVE
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