title: CD34(+) cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent.
abstract: BACKGROUND
  the objective of the study was to determine whether the effects of infarct-related artery (IRA) infusion of autologous bone marrow-derived CD34(+) cells after ST elevation myocardial infarction (STEMI) are dependent on the dose (quantity and mobility) of the cells infused. Beneficial effects of IRA infusion of mononuclear cells after STEMI have been inconsistent, possibly because of differences in timing, cell type, quantity, and mobility of infused cells.
  
  
  METHODS
  patients were randomized to bone marrow harvest (n = 16) or control (n = 15). At a median of 8.3 days after coronary stenting for STEMI, CD34(+) cells were infused via the IRA at 3 dose levels (5, 10, and 15 × 10(6)) in cohorts of 5 patients each. Baseline and follow-up imaging and ex vivo CD34(+) cell mobility were performed.
  
  
  RESULTS
  Cell harvest and infusion were safe. Quantitative rest hypoperfusion score measured by single-photon emission computed tomography improved at 6 months in the ≥ 10 million cohorts compared with controls (-256 vs +14, P = .02). There was a trend toward improved ejection fraction at 6 months (+4.5%) in the ≥ 10 million cohorts compared with no change in the controls and 5 million cohort (+0.7%). Improved perfusion and infarct size reduction correlated with the quantity and mobility of the infused CD34(+) cells.
  
  
  CONCLUSIONS
  the effects of CD34(+) cell IRA infusion during the repair phase after STEMI are dose dependent and, at a threshold dose of 10 million CD34(+) cells, associated with a significant improvement in perfusion that may limit deterioration in cardiac function (IRA infusion of CD34(+) cells in patients with acute myocardial infarction [AMR-01] NCT00313339).
authors.affiliation: Emory University, Atlanta, GA, USA. aquyyum@emary.edu
authors.forename: Arshed A
authors.initials: AA
authors.lastname: Quyyumi
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Waller
authors.forename: Jonathan
authors.initials: J
authors.lastname: Murrow
authors.forename: Fabio
authors.initials: F
authors.lastname: Esteves
authors.forename: James
authors.initials: J
authors.lastname: Galt
authors.forename: John
authors.initials: J
authors.lastname: Oshinski
authors.forename: Stamatios
authors.initials: S
authors.lastname: Lerakis
authors.forename: Salman
authors.initials: S
authors.lastname: Sher
authors.forename: Douglas
authors.initials: D
authors.lastname: Vaughan
authors.forename: Emerson
authors.initials: E
authors.lastname: Perin
authors.forename: James
authors.initials: J
authors.lastname: Willerson
authors.forename: Dean
authors.initials: D
authors.lastname: Kereiakes
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Douglas
authors.initials: D
authors.lastname: Gregory
authors.forename: Astrid
authors.initials: A
authors.lastname: Werner
authors.forename: Thomas
authors.initials: T
authors.lastname: Moss
authors.forename: Wai Shun
authors.initials: WS
authors.lastname: Chan
authors.forename: Robert
authors.initials: R
authors.lastname: Preti
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Pecora
mesh_terms: D018952:Antigens, CD34; D001854:Bone Marrow Cells / Q000276:immunology*; D016026:Bone Marrow Transplantation / Q000379:methods*; D003326:Coronary Circulation / Q000502:physiology*; D003331:Coronary Vessels; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34