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December 17, 2009European Heart Journal

Influence of bone marrow stem cells on left ventricle perfusion and ejection fraction in patients with acute myocardial infarction of anterior wall: randomized clinical trial: Impact of bone marrow stem cell intracoronary infusion on improvement of microcirculation

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Key result

Intracoronary transplantation of bone marrow stem cells in anterior AMI did not increase ejection fraction, but improved dipyridamole perfusion index at 6 months (2.26 vs 2.47; P=0.033).

Why the study?

Does intracoronary infusion of bone marrow stem cells improve left ventricle ejection fraction and myocardial perfusion in patients with anterior wall acute myocardial infarction?

Population

45 patients with acute myocardial infarction (AMI) of anterior wall

Comparison

Bone marrow stem cells administered into… vs Control group

Design

RCT, 2:1 to BMSC group or to control group

Follow-up

12 months

Authors

SGStefan GrajekPoznan University of Medical SciencesMPMałgorzata PopielRzeszów UniversityLGLidia GilPoznan University of Medical Sciences

Discussion

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Implication

Intracoronary BMSCs after anterior AMI may improve perfusion; leaves open LVEF benefit and clinical efficacy pending larger trials.

Study Design

Type

RCT (n=45)

Randomization

2:1

Structured PICO

Does intracoronary infusion of bone marrow stem cells improve left ventricle ejection fraction and myocardial perfusion in patients with anterior wall acute myocardial infarction?

P
Population
45 patients with acute myocardial infarction of anterior wall, followed for up to 12 months.
I
Intervention
Bone marrow stem cells (BMSCs) administered into infarct-related artery (IRA) at 4-6 days after primary PCI
C
Comparator
Control group
O
Outcome
Change in left ventricle ejection fraction (LVEF) and myocardial perfusion from baseline in the acute phase up to 12 months of follow-upsurrogate

Intracoronary bone marrow stem cell transplantation post-anterior AMI did not significantly increase LVEF but showed a slight improvement in myocardial perfusion during stress.

Limitations

  • Small number of patients
  • small number of patients

Cite This Study

Grajek et al. (2009) conducted an RCT in acute myocardial infarction (AMI) of anterior wall (n=45). Bone marrow stem cells (BMSCs) vs. Control group was evaluated on Change in left ventricle ejection fraction (LVEF) and myocardial perfusion. Intracoronary transplantation of bone marrow stem cells in anterior AMI did not increase ejection fraction, but improved dipyridamole perfusion index at 6 months (2.26 vs 2.47; P=0.033).

synapsesocial.com/papers/6a6af655547974b2dbf42e62https://doi.org/10.1093/eurheartj/ehp536

Topics

Echocardiography
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Intracoronary administration of autologous adipose tissue-derived stem cells improves left ventricular function, perfusion, and remodelling after acute myocardial infarction2007 · 392 citations
  2. 2Repair of Infarcted Myocardium by Autologous Intracoronary Mononuclear Bone Marrow Cell Transplantation in Humans2002 · 2,072 citations
  3. 3Angiographic Assessment of Myocardial Reperfusion in Patients Treated With Primary Angioplasty for Acute Myocardial Infarction1998 · 1,308 citations
  4. 4Restoration of Microvascular Function in the Infarct-Related Artery by Intracoronary Transplantation of Bone Marrow Progenitor Cells in Patients With Acute Myocardial Infarction2007 · 224 citations
  5. 5Safety and Feasibility of Catheter-Based Local Intracoronary Vascular Endothelial Growth Factor Gene Transfer in the Prevention of Postangioplasty and In-Stent Restenosis and in the Treatment of Chronic Myocardial Ischemia2003 · 540 citations