Impact of intracoronary injection of CD133+ bone marrow stem cells on coronary atherosclerotic progression in patients with STEMI: a COMPARE-AMI IVUS substudy.
OBJECTIVE
Adverse effects of intracoronary injection of stem cells on in-stent restenosis and atherosclerotic progression remain unclear. We sought to evaluate the adverse effects of intracoronary injection of CD133 cells on in-stent restenosis and atherosclerotic progression in the infarct-related and contralateral arteries using serial intravascular ultrasound (IVUS) analysis.


METHODS
Baseline and 4-month follow-up IVUS images were obtained from 17 patients treated with intracoronary stem cell injection and 20 placebo patients after primary percutaneous coronary intervention in the COMPARE-AMI trial. In the infarct-related artery, the stented segment, 5 mm proximal and distal reference segments, and proximal and distal nonstented segments were analyzed every 1 mm; the entire segment of a contralateral artery was also analyzed every 1 mm.


RESULTS
In the infarct-related artery analysis, the median percentage of in-stent neointimal hyperplasia (12.1 vs. 7.6%, P=0.95), the reduction in the minimum lumen area (MLA; -1.6 vs. -1.5 mm(2), P=0.97), and the MLA at follow-up (4.3 vs. 5.3 mm(2), P=0.21) were found to be similar between the stem cell and placebo groups. Changes in proximal and distal nonstented segment lumen areas and plaque burden were also similar between the stem cell and placebo groups; however, there was a decrease in the maximum arc of the attenuated plaque behind the stent from baseline to follow-up in the placebo group (P=0.004), but not in the stem cell group. In the contralateral artery, there were no differences in changes in MLA, plaque burden, or attenuated plaque between stem cell and placebo patients.


CONCLUSIONS
Intracoronary injection of CD133(+) bone marrow stem cells has no IVUS-detectable effect on neointimal hyperplasia or atherosclerosis progression in either infarct-related or contralateral arteries.
aCardiovascular Research Foundation bColumbia University Medical Center/New York-Presbyterian Hospital, New York, New York, USA cSir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China dCentre Hospitalier de l'Université de Montréal eDepartment of Medicine, Faculty of Medicine, Université de Montréal fHôpital du Sacré-Coeur de Montréal gCentre de recherche du Centre Hospitalier de l'Université de Montréal hHôpital Maisonneuve-Rosemont, Montréal, Québec, Canada.
Fuyu
F
Qiu
Akiko
A
Maehara
Ramez
R
El Khoury
Philippe
P
Généreux
Laura
L
LaSalle
Gary S
GS
Mintz
Nicolas
N
Noiseux
Denis-Claude
DC
Roy
François
F
Gobeil
Louis-Mathieu
LM
Stevens
François
F
Reeves
Guy
G
Leclerc
Alain
A
Rivard
Samer
S
Mansour
D000071916:AC133 Antigen; D000328:Adult; D015703:Antigens, CD / Q000276:immunology*; D050197:Atherosclerosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D001854:Bone Marrow Cells / Q000166:cytology / Q000276:immunology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels; D004311:Double-Blind Method; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000276:immunology*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006412:Hematopoietic Stem Cells / Q000166:cytology / Q000276:immunology*; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D010455:Peptides / Q000276:immunology*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides