Effects of intracoronary injection of mononuclear bone marrow cells on left ventricular function, arrhythmia risk profile, and restenosis after thrombolytic therapy of acute myocardial infarction.
OBJECTIVE
To assess the efficacy and safety of bone marrow cell (BMC) therapy after thrombolytic therapy of an acute ST-elevation myocardial infarction (STEMI).


RESULTS
Patients with STEMI treated with thrombolysis followed by percutaneous coronary intervention (PCI) 2-6 days after STEMI were randomly assigned to receive intracoronary BMCs (n = 40) or placebo medium (n = 40), collected and prepared 3-6 h prior PCI and injected into the infarct artery immediately after stenting. Efficacy was assessed by the measurement of global left ventricular ejection fraction (LVEF) by left ventricular angiography and 2-D echocardiography, and safety by measuring arrhythmia risk variables and restenosis of the stented vessel by intravascular ultrasound. At 6 months, BMC group had a greater absolute increase of global LVEF than placebo group, measured either by angiography (mean +/- SD increase 7.1 +/- 12.3 vs. 1.2 +/- 11.5%, P = 0.05) or by 2-D echocardiography (mean +/- SD increase 4.0 +/- 11.2 vs. -1.4 +/- 10.2%, P = 0.03). No differences were observed between the groups in the adverse clinical events, arrhythmia risk variables, or the minimal lumen diameter of the stented coronary lesion.


CONCLUSIONS
Intracoronary BMC therapy is associated with an improvement of global LVEF and neutral effects on arrhythmia risk profile and restenosis of the stented coronary lesions in patients after thrombolytic therapy of STEMI.
Huikuri
Heikki V
HV
Department of Internal Medicine, University of Oulu, Oulu, Finland. heikki.huikuri@oulu.fi
Kervinen
Kari
K
Niemelä
Matti
M
Ylitalo
Kari
K
Säily
Marjaana
M
Koistinen
Pirjo
P
Savolainen
Eeva-Riitta
ER
Ukkonen
Heikki
H
Pietilä
Mikko
M
Airaksinen
Juhani K E
JK
Knuuti
Juhani
J
Mäkikallio
Timo H
TH
D001145:Arrhythmias, Cardiac / Q000175:diagnosis / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate; D006801:Humans; D007269:Injections, Intra-Arterial; D007963:Leukocytes, Mononuclear / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000601:surgery*; D018570:Risk Assessment; D015607:Stents; D013318:Stroke Volume / Q000502:physiology; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*