Abstract 1014: The Impact Of Intravenous Allogeneic Human Mesenchymal Stem Cells (Provacel™) On Ejection Fraction In Patients With Myocardial Infarction
Background: Mesenchymal stem cells (MSC) ameliorate the damage due to myocardial infarction (MI) in preclinical studies. These cells have a number of unique advantages including their use as an allogeneic graft and the capacity to home to areas of injury, thus facilitating intravenous infusion. In animal models, intravenous MSC home to regions of MI. Here we tested whether infarct location affected the response to intravenous MSCs in humans.
Methods: We analyzed data from a double-blind, placebo controlled trial to assess the safety of MSCs infused intravenously in patients reperfused within 10-days of an index MI. Echocardiography was performed at baseline, 3 and 6 months to determine ejection fraction, and infarct related artery (IRA) was determined by angiography. We used t-test and linear regression with interaction terms between IRA and randomized group.
Results: Baseline EF was not different between patients with left anterior descending artery (LAD; 50.4 ± 10.5%; n=27) vs. non-LAD (48.7 ± 9.6%; n=25) MIs. In patients with LAD MIs, MSC therapy led to an increase in EF at 3 (48.8 ± 11.9 vs 57.1 ± 8.2; P 0.02) and and 6 months (56.3 ± 8.7; P=0.05). Changes in EF in the placebo patients and the non LAD groups were not significant.
Conclusion: The use of IV allogenic MSC in this randomized trial significantly improved cardiac performance. Patients with infarcts in the LAD distribution appear to respond preferentially. The degree of response to IV therapy occurs early after MI and compares favorably with previous studies using intacoronary infusions of bone marrow.