title: Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction.
abstract: BACKGROUND
  Pilot trials suggest that the intracoronary administration of autologous progenitor cells may improve left ventricular function after acute myocardial infarction.
  
  
  METHODS
  In a multicenter trial, we randomly assigned 204 patients with acute myocardial infarction to receive an intracoronary infusion of progenitor cells derived from bone marrow (BMC) or placebo medium into the infarct artery 3 to 7 days after successful reperfusion therapy.
  
  
  RESULTS
  At 4 months, the absolute improvement in the global left ventricular ejection fraction (LVEF) was significantly greater in the BMC group than in the placebo group (mean [+/-SD] increase, 5.5+/-7.3% vs. 3.0+/-6.5%; P=0.01). Patients with a baseline LVEF at or below the median value of 48.9% derived the most benefit (absolute improvement in LVEF, 5.0%; 95% confidence interval, 2.0 to 8.1). At 1 year, intracoronary infusion of BMC was associated with a reduction in the prespecified combined clinical end point of death, recurrence of myocardial infarction, and any revascularization procedure (P=0.01).
  
  
  CONCLUSIONS
  Intracoronary administration of BMC is associated with improved recovery of left ventricular contractile function in patients with acute myocardial infarction. Large-scale studies are warranted to examine the potential effects of progenitor-cell administration on morbidity and mortality.
authors.affiliation: Department of Internal Medicine III, Johann Wolfgang Goethe University, Frankfurt, Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Schächinger
authors.forename: Sandra
authors.initials: S
authors.lastname: Erbs
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.forename: Werner
authors.initials: W
authors.lastname: Haberbosch
authors.forename: Rainer
authors.initials: R
authors.lastname: Hambrecht
authors.forename: Hans
authors.initials: H
authors.lastname: Hölschermann
authors.forename: Jiangtao
authors.initials: J
authors.lastname: Yu
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
authors.forename: Detlef G
authors.initials: DG
authors.lastname: Mathey
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.forename: Tim
authors.initials: T
authors.lastname: Süselbeck
authors.forename: Birgit
authors.initials: B
authors.lastname: Assmus
authors.forename: Torsten
authors.initials: T
authors.lastname: Tonn
authors.forename: Stefanie
authors.initials: S
authors.lastname: Dimmeler
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Zeiher
mesh_terms: D000368:Aged; D016026:Bone Marrow Transplantation / Q000379:methods; D017023:Coronary Angiography; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D033581:Stem Cell Transplantation / Q000379:methods; D013318:Stroke Volume; D014182:Transplantation, Autologous; D016277:Ventricular Function, Left