title: Intracoronary administration of stem cells in patients with acute myocardial infarction - angiographic follow-up.
abstract: BACKGROUND
  Even up-to-date reperfusion therapy using primary percutaneous intervention (PCI) in acute myocardial infarction does not result in improvement of the left ventricular (LV) function in all patients. Cellular myoblasty, a novel method using mononuclear bone marrow cells (BMC), can be applied in the infarcted myocardium area to stimulate regeneration and to limit the organ damage. However, the impact of intracoronary BMC administration on the effect of PCI is not clear.
  
  
  OBJECTIVE
  To assess angiographic outcomes in patients with anterior myocardial infarction and LV dysfunction, undergoing intracoronary BMC administration after a successful primary PCI.
  
  
  METHODS
  The study group consisted of 40 patients (mean age 56.2 years) with LV ejection fraction below 40%, in whom 20 ml of BMC were administered to the infarct-related artery (IRA) distally to the occlusion. The control group comprised 25 age- and sex-matched patients with similar values of LV ejection fraction undergoing bare metal stenting of IRA without BMC administration. Quantitative coronary angiography was performed 6 months later to assess IRA patency.
  
  
  RESULTS
  The reference diameter of the stented artery decreased in the study group from 3.22 +/- 0.28 mm to 3.16 +/- 0.18 mm (p < 0.05) and in the control group from 3.22 +/- 0.31 mm to 3.15 +/- 0.28 mm (p < 0.082); also in the area of the implanted stent the diameter decreased from 3.57 +/- 0.21 mm to 2.96 +/- 0.79 mm in the study group vs. 3.48 +/- 0.22 mm to 3.01 +/- 0.35 mm in the control group. For lumen diameter measured 10 mm distally to the stent, the diameter loss was similar in both groups. In 6 patients from the BMC treated group and in 3 patients from the control group there was asymptomatic lumen reduction > 70% (NS).
  
  
  CONCLUSIONS
  The results of our study show that BMC administration into IRA is safe. The degree of lumen loss in the stent area was larger in the BMC group than in the control group. There was no significant difference in the lumen change distally to the stent; the artery diameter loss in both groups was similar, and the improvement in LV ejection fraction was greater in the BMC-treated group.
authors.affiliation: 2nd Department of Cardiology, Medical University, Łódź, Poland. jzperuga@op.pl
authors.forename: Jan
authors.initials: J
authors.lastname: Peruga
authors.forename: Michał
authors.initials: M
authors.lastname: Plewka
authors.forename: Jarosław
authors.initials: J
authors.lastname: Kasprzak
authors.forename: Tomasz
authors.initials: T
authors.lastname: Jezewski
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Wierzbicka
authors.forename: Tadeusz
authors.initials: T
authors.lastname: Robak
authors.forename: Maria
authors.initials: M
authors.lastname: Krzemińska-Pakuła
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016026:Bone Marrow Transplantation; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D033581:Stem Cell Transplantation; D015607:Stents; D013318:Stroke Volume; D016896:Treatment Outcome; D016277:Ventricular Function, Left