Abstract 15217: The Influence of Patient Characteristics on Treatment Outcome of Bone Marrow Cell Injection in Patients with Chronic Myocardial Ischemia
Background: Clinical studies have demonstrated mixed results on treatment outcome of bone marrow cell (BMC) injection in patients with chronic myocardial disease. It is unclear whether patient characteristics determine treatment outcome. We therefore explored if patient characteristics are correlated with treatment outcome after intramyocardial BMC injection in patients with refractory angina and chronic myocardial ischemia.
Methods and Results: In 96 patients with refractory angina and chronic stress-inducible ischemia, myocardial perfusion (assessed by Tc-99m tetrofosmin SPECT) was evaluated before and 3 months after intramyocardial BMC injection. Summed stress score improved from 26.2±6.61 to 22.6±5.93 (P<0.01) after 3 months follow up. Overall, this corresponded to an improvement in 45% (median) of total ischemic burden (IB) (number of ischemic segments x ischemia severity). Comparing treatment effect between non-responders (no effect on IB or worsening), low responders (improvement below 45% of IB) and high responders (45% improvement of IB and higher), demonstrated that the presence of diabetes mellitus (P<0.05) and hyperlipidemia (P<0.05) was associated with a high treatment effect. Post hoc analyses revealed that the presence of hypertension was associated with a high response to treatment as compared to non-responders (P<0.05). (Table 1)
Conclusion: The current study shows that intramyocardial injection of BMC in patients with chronic myocardial ischemia is associated with an improved myocardial perfusion. Furthermore, the presence of diabetes mellitus, hyperlipidemia and hypertension is associated with a high response to BMC treatment in these patients. Identifying which patient will benefit most from BMC treatment may improve patient selection and optimize cell therapy.
- © 2011 by American Heart Association, Inc.