title: Intra-coronary bone marrow mononuclear cell transplantation in patients with ST-elevation myocardial infarction: a randomized controlled study.
abstract: BACKGROUND
  Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction (LVEF) after ST elevation myocardial infarction (STEMI). However, the outcomes still are controversial.
  
  
  OBJECTIVE
  To determine the 6-month LVEF of the patients who underwent intra-coronary bone marrow mononuclear cell (BMC) transplantation in patients with STEMI compared with controlled subjects.
  
  
  METHODS
  After successful percutaneous coronary intervention (PCI) in STEMI patients who had LVEF was less than 50% were randomized to intra-coronary BMC transplantation or control. Bone marrow aspiration of 100 cc was performed in the morning. After cellprocessing for three hours, the suspension of BMC about 10 cc were infused to infracted area using standard PCI technique. Balloon occlusion for three minutes was performed during cell infusion. Cardiac magnetic resonance imaging was used to determine LVEF scar volume and LV volume before and six-month follow-up.
  
  
  RESULTS
  Between September 2006 and July 2008, 23patients (11 in BMC group and 12 in control group) were enrolled. Mean BMC count before transplant was 420 x 10(6) cell with 96% viability. At six-month follow-up, New York Heart Association function class significantly improved in both groups (2.3 +/- 0.6 to 1.2 +/- 0. 4 for BMC and 2.3 +/- 0.7 to 1.3 +/- 0.5 for control group) but no difference was seen between groups. However, scar volume, wall motion score index, and LVEF did not show improvement after six months in both groups (33.7 +/- 7.7 to 33.5 +/- 7.6 for BMC and 31.1 +/- 7.1 to 32.6 +/- 8.3 for control group). No complication was observed during the procedure.
  
  
  CONCLUSIONS
  BMC transplantation intra-coronary in patients with STEMI in KCMH was feasible and safe but LVEF improvement could not be demonstrated.
authors.affiliation: Division of Cardiology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. s_srimahachota@yahoo.co.th
authors.forename: Suphot
authors.initials: S
authors.lastname: Srimahachota
authors.forename: Smonporn
authors.initials: S
authors.lastname: Boonyaratavej
authors.forename: Pairoj
authors.initials: P
authors.lastname: Rerkpattanapipat
authors.forename: Somjai
authors.initials: S
authors.lastname: Wangsupachart
authors.forename: Monravee
authors.initials: M
authors.lastname: Tumkosit
authors.forename: Udomsak
authors.initials: U
authors.lastname: Bunworasate
authors.forename: Thayapong Na
authors.initials: TN
authors.lastname: Nakorn
authors.forename: Tanin
authors.initials: T
authors.lastname: Intragumtornchai
authors.forename: Pawinee
authors.initials: P
authors.lastname: Kupatawintu
authors.forename: Sunisa
authors.initials: S
authors.lastname: Pongam
authors.forename: Aem-Orn
authors.initials: AO
authors.lastname: Saengsiri
authors.forename: Mantana
authors.initials: M
authors.lastname: Pothisri
authors.forename: Yeesoon
authors.initials: Y
authors.lastname: Sukseri
authors.forename: Tanorm
authors.initials: T
authors.lastname: Bunprasert
authors.forename: Taworn
authors.initials: T
authors.lastname: Suithichaiyakul
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D001854:Bone Marrow Cells / Q000473:pathology; D016026:Bone Marrow Transplantation; D004452:Echocardiography; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D033581:Stem Cell Transplantation; D013318:Stroke Volume / Q000502:physiology; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology