Key result
Repeated intramyocardial bone marrow cell injection in patients with refractory angina improved myocardial perfusion summed stress score from 27.3 at baseline to 25.4 at 12 months (P=0.002).
Why the study?
Does repeated intramyocardial injection of autologous bone marrow mononuclear cells improve myocardial perfusion and symptoms in patients with refractory angina who previously responded but have recurrent ischemia?
Does repeated intramyocardial injection of autologous bone marrow mononuclear cells improve myocardial perfusion and symptoms in patients with refractory angina who previously responded but have recurrent ischemia?
Repeated intramyocardial bone marrow cell injection in patients with refractory angina and recurrent ischemia safely improves myocardial perfusion, angina symptoms, and quality of life up to 12 months.
BACKGROUND: Intramyocardial bone marrow cell injection is associated with improvements in myocardial perfusion and anginal symptoms in patients with refractory angina pectoris. This study evaluates the effect of repeated intramyocardial bone marrow cell injection in patients with residual or recurrent myocardial ischemia. METHODS AND RESULTS: Twenty-three patients (17 men; 69±9 years) who had improved myocardial perfusion after the first injection but had residual or recurrent angina and ischemia on single-photon emission computed tomographic myocardial perfusion imaging were included. Patients again received intramyocardial injection of 100×10(6) autologous bone marrow mononuclear cells, 4.6±2.5 years after their first injection. No periprocedural complications occurred. Myocardial perfusion assessed using single-photon emission computed tomographic myocardial perfusion imaging improved from a summed stress score of 27.3±5.8 at baseline to 24.5±4.4 at 3 months (P=0.002) and 25.4±4.9 at 12 months of follow-up (P=0.002). Perfusion improvement after 3 months was comparable with the effect of the first injection (P=0.379). Anginal complaints improved ≤12 months after cell injection in Canadian Cardiovascular Society score (mean change at 3, 6, and 12 months: 0.6±0.9%, 0.5±0.9%, and 0.6±0.9%, respectively; Pslope=0.007, first versus repeated; P=0.188) and in quality of life score as measured by Seattle Angina Questionnaire (mean change at 3, 6, and 12 months: 7±14%, 8±14%, and 7±15%, respectively; Pslope=0.020, first versus repeated; P=0.126). CONCLUSIONS: Repeated bone marrow cell injection in previously responding patients with refractory angina is associated with improvements in myocardial perfusion, anginal complaints, and quality of life score ≤12 months of follow-up. CLINICAL TRIAL REGISTRATION: URL: http://www.trialregister.nl. Unique identifier: NTR2664.
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Mann et al. (2015) studied Refractory angina pectoris with residual or recurrent myocardial ischemia (n=23). Repeated intramyocardial bone marrow cell injection vs. Baseline was evaluated on Myocardial perfusion (summed stress score) (p=0.002). Repeated intramyocardial bone marrow cell injection in patients with refractory angina improved myocardial perfusion summed stress score from 27.3 at baseline to 25.4 at 12 months (P=0.002).
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