Improved clinical outcome after intracoronary administration of bone-marrow-derived progenitor cells in acute myocardial infarction: final 1-year results of the REPAIR-AMI trial.
OBJECTIVE
To investigate the clinical outcome after intracoronary administration of autologous progenitor cells in patients with acute myocardial infarction (AMI).


RESULTS
Using a double-blind, placebo-controlled multicentre trial design, we randomized 204 patients with successfully reperfused AMI to receive intracoronary infusion of bone-marrow-derived progenitor cells (BMCs) or placebo medium into the infarct artery 3-7 days after successful infarct reperfusion therapy. At 12 months, the pre-specified cumulative endpoint of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (P=0.009). Likewise, the combined endpoint death, recurrence of myocardial infarction, and rehospitalization for heart failure was significantly (P=0.006) reduced in patients receiving intracoronary BMC administration. Intracoronary administration of BMC remained a significant predictor of a favourable clinical outcome by Cox regression analysis, adjusting for classical predictors of poor outcome after AMI.


CONCLUSIONS
Intracoronary administration of BMCs is associated with a significant reduction of the occurrence of major adverse cardiovascular events after AMI. Large-scale studies are warranted to confirm the effects of BMC administration on mortality and morbidity in patients with AMIs.
Schächinger
Volker
V
J. W. Goethe Universität Frankfurt, Med. Klinik III, Abt. Kardiologie, Theodor-Stern-Kai 7, 60590 Frankfurt a. M., Germany.
Erbs
Sandra
S
Elsässer
Albrecht
A
Haberbosch
Werner
W
Hambrecht
Rainer
R
Hölschermann
Hans
H
Yu
Jiangtao
J
Corti
Roberto
R
Mathey
Detlef G
DG
Hamm
Christian W
CW
Süselbeck
Tim
T
Werner
Nikos
N
Haase
Jürgen
J
Neuzner
Jörg
J
Germing
Alfried
A
Mark
Bernd
B
Assmus
Birgit
B
Tonn
Torsten
T
Dimmeler
Stefanie
S
Zeiher
Andreas M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004311:Double-Blind Method; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D012008:Recurrence; D016896:Treatment Outcome