Abstract 15027: Repeated Intracoronary Administration of Bone Marrow-Derived Mononuclear Cells is Associated With Improved Survival in Patients With Chronic Post-Infarction Heart Failure
Background: Recent data suggest that cell-based therapies can improve cardiac function in patients with chronic heart failure (CHF). However, concern has been raised regarding the sustained clinical benefit after a single cell administration in patients with CHF. Therefore, we tested whether repeated intracoronary administration of bone marrow-derived mononuclear cells (BM-MNC) is associated with better clinical outcome compared to single BM-MNC administration.
Methods: All-cause mortality was assessed in 297 consecutive patients (age 62±11 yrs; ) receiving single (n=188) or repeated (n=109) intracoronary administration of BM-MNC for post-infarction CHF (> 3 months post-AMI; mean 88.5±88.9 months post AMI) between 2002 and 2007 at a single center. Observed mortality during 3 years of follow-up was compared with the Seattle Heart Failure Model-predicted mortality, a validated multivariate mortality risk prediction model.
Results: Baseline mean SHFM score was comparable between the groups, indicating similar risk profile. During a total time at risk of 781 patient-years, observed mortality rates were consistently lower compared to SHFM-predicted mortality in patients receiving repeated BM-MNC (14.1% observed compared to 24.4% predicted mortality at 3 years), but not in patients receiving a single cell administration ( 21.8% observed vs. 21% predicted). Multivariable Cox regression analysis including baseline SHFM score into computation documented a significantly (p<0.016) reduced mortality in patients receiving repeated BM-MNC administration (see fig).
Conclusions: Repeated intracoronary administration of autologous bone marrow-derived mononuclear cells is associated with significantly improved survival in patients with chronic post-infarction heart failure receiving optimal medical treatment. Trial registration: The study is registered within www.clinicaltrials.gov (NCT00962364).
- © 2010 by American Heart Association, Inc.