title: Difference in mobilization of progenitor cells after myocardial infarction in smoking versus non-smoking patients: insights from the BONAMI trial.
abstract: BACKGROUND
  Although autologous bone marrow cell (BMC) therapy has emerged as a promising treatment for acute myocardial infarction (AMI), trials reported mixed results. In the BONAMI trial, active smoking reduced cardiac function recovery after reperfused AMI. Therefore, we hypothesized that variability in the functionality of BMCs retrieved from patients with cardiovascular risk factors may partly explain these mixed results. We investigated the characteristics of progenitor cells in active smokers and non-smokers with AMI and their potential impact on BMC therapy efficacy.
  
  
  METHODS
  Bone marrow and blood samples from 54 smoking and 47 non-smoking patients enrolled in the BONAMI cell therapy trial were analyzed.
  
  
  RESULTS
  The white BMC and CD45dimCD34+ cell numbers were higher in active smokers (P = 0.001, P = 0.03, respectively). In marked contrast, either bone marrow or blood endothelial progenitor CD45dimCD34 + KDR + cells (EPCs) were decreased in active smokers (P = 0.005, P = 0.04, respectively). Importantly, a multivariate analysis including cardiovascular risk factors confirmed the association between active smoking and lower EPC number in bone marrow (P = 0.04) and blood (P = 0.04). Furthermore, baseline circulating EPC count predicted infarct size decrease at three months post-AMI in non-smokers (P = 0.01) but not in active smokers. Interestingly, baseline circulating EPCs were no longer predictive of cardiac function improvement in the BMC therapy group.
  
  
  CONCLUSIONS
  These data suggest that circulating EPCs play an important role in cardiac repair post-AMI only in non-smokers and that active smoking-associated EPC alterations may participate in the impairment of cardiac function recovery observed in smokers after AMI, an effect that was overridden by BMC therapy.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lamirault
authors.forename: Sophie
authors.initials: S
authors.lastname: Susen
authors.forename: Virginie
authors.initials: V
authors.lastname: Forest
authors.forename: Caroline
authors.initials: C
authors.lastname: Hemont
authors.forename: Angelo
authors.initials: A
authors.lastname: Parini
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Corvoisier
authors.forename: Christophe
authors.initials: C
authors.lastname: Piot
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Richard
authors.forename: Béatrice
authors.initials: B
authors.lastname: Delasalle
authors.forename: Hélène
authors.initials: H
authors.lastname: Rouard
authors.forename: Catherine
authors.initials: C
authors.lastname: Sportouch
authors.forename: Virginie
authors.initials: V
authors.lastname: Persoons
authors.forename: Eric
authors.initials: E
authors.lastname: Van Belle
authors.forename: Jérôme
authors.initials: J
authors.lastname: Roncalli
authors.forename: Patricia
authors.initials: P
authors.lastname: Lemarchand
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000378:metabolism; D001854:Bone Marrow Cells / Q000166:cytology; D016026:Bone Marrow Transplantation; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D017493:Leukocyte Common Antigens / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000601:surgery*; D012907:Smoking; D020257:Ventricular Remodeling; D055815:Young Adult
chemical_list: D018952:Antigens, CD34; D017493:Leukocyte Common Antigens