Effects of intracoronary injection of autologous bone marrow-derived stem cells on natriuretic peptides and inflammatory markers in patients with acute ST-elevation myocardial infarction.
BACKGROUND
Intracoronary administration of autologous bone marrow stem cells (BMC) has been shown to result in a subtle improvement of global left ventricular ejection fraction after ST-elevation myocardial infarction (STEMI), but the overall benefits of BMC therapy are still unclear. We studied the influence of intracoronary injections of BMC on levels of natriuretic peptides and inflammatory mediators, which are well established prognostic biomarkers, in patients with STEMI.


METHODS
In this randomized, double-blind study, consecutive patients with an acute STEMI treated with thrombolysis followed by PCI 2-6 days after STEMI, were randomly assigned to receive either intracoronary BMC or placebo medium into the infarct-related artery. Blood samples were drawn for biochemical determinations.


RESULTS
From baseline to 6 months, there was a significant decrease in the levels of N-terminal probrain natriuretic peptide (NT-proBNP), interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) in the whole patient population (P < 0.001 for all). However, no difference was observed between the BMC group (n = 39) and the placebo group (n = 39) in the change of the levels of NT-proANP (median -54 vs. +112 pmol/L), NT-proBNP (-88 vs. -115 pmol/L) or inflammatory markers IL-6 (-3.86 vs. -5.61 pg/mL), hsCRP (-20.29 vs. -22.36 mg/L) and tumor necrosis factor α (-0.12 vs. -0.80 pg/mL) between baseline and 6 months.


CONCLUSIONS
Intracoronary BMC therapy does not appear to exert any significant effects on the secretion of natriuretic peptides or inflammatory biomarkers in STEMI patients.
Miettinen
Johanna A
JA
Department of Internal Medicine, Institute of Clinical Medicine, University of Oulu, Kajaanintie 50, Oulu, Finland. johanna.miettinen@oulu.fi
Ylitalo
Kari
K
Hedberg
Pirjo
P
Kervinen
Kari
K
Niemelä
Matti
M
Säily
Marjaana
M
Koistinen
Pirjo
P
Savolainen
Eeva-Riitta
ER
Ukkonen
Heikki
H
Pietilä
Mikko
M
Airaksinen
K E Juhani
KE
Knuuti
Juhani
J
Vuolteenaho
Olli
O
Mäkikallio
Timo H
TH
Huikuri
Heikki V
HV
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016026:Bone Marrow Transplantation; D002097:C-Reactive Protein / Q000378:metabolism; D003331:Coronary Vessels; D004311:Double-Blind Method; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007269:Injections, Intra-Arterial; D015850:Interleukin-6 / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D045265:Natriuretic Peptides / Q000097:blood*; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
D015415:Biomarkers; D015850:Interleukin-6; D045265:Natriuretic Peptides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein