title: Intracoronary injection of bone marrow-derived mononuclear cells early or late after acute myocardial infarction: effects on global left ventricular function.
abstract: BACKGROUND
  Intracoronary administration of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction. The optimal time point of administration of BM-MNC is still uncertain and has rarely been addressed prospectively in randomized clinical trials.
  
  
  RESULTS
  In a multicenter study, we randomized 200 patients with large, successfully reperfused ST-segment elevation myocardial infarction in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were administered either early (i.e., 5 to 7 days) or late (i.e., 3 to 4 weeks) after acute myocardial infarction. Cardiac magnetic resonance imaging was performed at baseline and after 4 months. The primary end point was the change from baseline to 4 months in global LV ejection fraction between the 2 treatment groups and the control group. The absolute change in LV ejection fraction from baseline to 4 months was -0.4±8.8% (mean±SD; P=0.74 versus baseline) in the control group, 1.8±8.4% (P=0.12 versus baseline) in the early group, and 0.8±7.6% (P=0.45 versus baseline) in the late group. The treatment effect of BM-MNC as estimated by ANCOVA was 1.25 (95% confidence interval, -1.83 to 4.32; P=0.42) for the early therapy group and 0.55 (95% confidence interval, -2.61 to 3.71; P=0.73) for the late therapy group.
  
  
  CONCLUSIONS
  Among patients with ST-segment elevation myocardial infarction and LV dysfunction after successful reperfusion, intracoronary infusion of BM-MNC at either 5 to 7 days or 3 to 4 weeks after acute myocardial infarction did not improve LV function at 4-month follow-up.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00355186.
authors.affiliation: Department of Cardiology, Cardiovascular Center, University Hospital Zurich, 8091 Zürich, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Sürder
authors.forename: Robert
authors.initials: R
authors.lastname: Manka
authors.forename: Viviana
authors.initials: V
authors.lastname: Lo Cicero
authors.forename: Tiziano
authors.initials: T
authors.lastname: Moccetti
authors.forename: Kaspar
authors.initials: K
authors.lastname: Rufibach
authors.forename: Sabrina
authors.initials: S
authors.lastname: Soncin
authors.forename: Lucia
authors.initials: L
authors.lastname: Turchetto
authors.forename: Marina
authors.initials: M
authors.lastname: Radrizzani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Astori
authors.forename: Juerg
authors.initials: J
authors.lastname: Schwitter
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
authors.forename: Michel
authors.initials: M
authors.lastname: Zuber
authors.forename: Christoph
authors.initials: C
authors.lastname: Auf der Maur
authors.forename: Peiman
authors.initials: P
authors.lastname: Jamshidi
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Aris
authors.initials: A
authors.lastname: Moschovitis
authors.forename: Andreas
authors.initials: A
authors.lastname: Wahl
authors.forename: Ines
authors.initials: I
authors.lastname: Bühler
authors.forename: Christophe
authors.initials: C
authors.lastname: Wyss
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kozerke
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Roberto
authors.initials: R
authors.lastname: Corti
mesh_terms: D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000502:physiology*; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007267:Injections; D007963:Leukocytes, Mononuclear / Q000502:physiology / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
keywords: bone marrow–derived progenitor cells; magnetic resonance imaging; myocardial infarction; regeneration; ventricular remodeling