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October 7, 2002Circulation

Repair of Infarcted Myocardium by Autologous Intracoronary Mononuclear Bone Marrow Cell Transplantation in Humans

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Key result

Intracoronary bone marrow cell transplantation reduces infarct size at 3 months versus standard therapy alone.

  • P=0.04
  • n=20

Why the study?

Experimental data suggest that bone marrow-derived cells may contribute to healing after myocardial infarction, but clinical evidence was needed.

Does intracoronary transplantation of autologous mononuclear bone marrow cells improve infarct size and cardiac function in patients with acute myocardial infarction?

Comparison

Intracoronary transplantation of autologous mononuclear bone marrow cells plus standard therapy vs standard therapy alone

Design

Non-randomized cohort study

Follow-up

3 months

Authors

BSBodo E. StrauerHeart Failure / CardiomyopathyMBMichael BrehmMedizinische Hochschule HannoverTZTobias ZeusStructural Heart Disease

Discussion

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Implication

May reduce infarct size post-MI; leaves open efficacy and safety in randomized trials.

Key Points

  • To evaluate the clinical safety and efficacy of intracoronary autologous mononuclear bone marrow cell transplantation for repairing damaged myocardium after acute myocardial infarction.
  • Assigned 10 acute myocardial infarction patients to receive intracoronary transplantation of autologous mononuclear bone marrow cells via balloon catheter during angioplasty in addition to standard therapy.
  • Compared outcomes against a control group of 10 acute myocardial infarction patients treated with standard therapy alone.
  • Evaluated myocardial function, infarct size, and regional perfusion at 3 months using left ventriculography, dobutamine stress echocardiography, and radionuclide ventriculography.
  • At 3 months, the infarct region decreased significantly in the cell therapy group from 30±13% to 12±7% (P=0.005) and was significantly smaller than in the standard therapy group (P=0.04).
  • Infarction wall movement velocity increased significantly only within the cell therapy group, rising from 2.0±1.1 to 4.0±2.6 cm/s (P=0.028).
  • Patients receiving cell therapy exhibited marked gains in stroke volume index, contractility, left ventricular end-systolic volume, and myocardial perfusion of the infarcted tissue.

Structured PICO

Does intracoronary transplantation of autologous mononuclear bone marrow cells improve infarct size and cardiac function in patients with acute myocardial infarction?

P
Population
20 patients with acute myocardial infarction, followed for 3 months.
I
Intervention
Intracoronary transplantation of autologous, mononuclear bone marrow cells (BMCs) via a balloon catheter placed into the infarct-related artery during balloon dilatation (percutaneous transluminal coronary angioplasty), in addition to standard therapy.
C
Comparator
Standard therapy alone.
O
Outcome
Infarct region size determined by left ventriculography at 3 months follow-up.surrogate

Main Result

p-value: p=0.04

Intracoronary transplantation of autologous mononuclear bone marrow cells after acute MI is safe and significantly reduces infarct size while improving cardiac function at 3 months.

Cite This Study

Strauer et al. (2002) studied acute myocardial infarction (n=20). Intracoronary transplantation of autologous mononuclear bone marrow cells vs. Standard therapy alone was evaluated on Infarct region size determined by left ventriculography (p=0.04). Intracoronary transplantation of autologous mononuclear bone marrow cells significantly reduced the infarct region compared with standard therapy alone at 3 months (P=0.04).

synapsesocial.com/papers/69ffcb6b7e61d2a3f0c22fe9https://doi.org/10.1161/01.cir.0000034046.87607.1c
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Also Consider

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