Randomized controlled trial on the cardioprotective effect of bone marrow cells in patients undergoing coronary bypass graft surgery.
OBJECTIVE
This randomized study investigates whether bone marrow cells (BMCs) can reduce ischaemic injury during cardiac surgery.


RESULTS
Forty-four elective coronary artery bypass grafting patients were randomized to control group or BMCs group (whereby autologous BMCs were administered with each dose of cardioplegia antegradely into the coronaries). Troponin I and CK-MB were measured during the first 48 h after surgery and were not significantly different between the control and BMCs groups. The role of cardiopulmonary bypass (CPB) on the cardioprotective effects of BMCs was also studied using an in vitro model of stimulated ischaemia and reoxygenation on right atrial appendages obtained from controls either before or 10 min after the initiation of CPB. Bone marrow cells significantly reduced myocardial injury in muscles obtained prior to CPB. This effect was comparable with ischaemic preconditioning (IP), although their combination did not afford additional benefit. However, when muscles were harvested after CPB, myocardial injury in the ischaemic group alone was less, and BMCs or IP did not exert further protection.


CONCLUSIONS
Bone marrow cells did not afford additional benefit when used as an additive to cardioplegia during CPB. However, BMCs offer cardioprotection as potent as IP, when the heart is not subjected to stress, such as CPB, that per se can precondition the myocardium.
Lai
Vien Khach
VK
Cardiac Surgery Unit, Department of Cardiovascular Sciences, University of Leicester, Clinical Science Wing, Glenfield Hospital, Leicester LE3 9QP, UK.
Ang
Keng-Leong
KL
Rathbone
Wendy
W
Harvey
Nicholas James
NJ
Galiñanes
Manuel
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016026:Bone Marrow Transplantation / Q000379:methods*; D001026:Coronary Artery Bypass / Q000379:methods*; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000517:prevention & control*; D012307:Risk Factors; D019210:Troponin I / Q000378:metabolism; D055815:Young Adult
D019210:Troponin I; D052279:Creatine Kinase, MB Form