BACKGROUND: Previous studies showed improvement in heart function by injecting bone marrow mesenchymal stem cells (BMSCs) after AMI. Emerging evidence suggested that both the number and function of BMSCs decline with ageing. We designed a randomized, controlled trial to further investigate the safety and efficacy of this treatment. METHODS:Patients with ST-elevation AMI undergoing successful reperfusion treatment within 12 hours were randomly assigned to receive an intracoronary infusion of BMSCs (n=21) or standard medical treatment (n=22) (the numbers of patients were limited because of the complication of coronary artery obstruction). RESULTS: There is a closely positive correlation of the number and function of BMSCs vs. the cardiac function reflected by LVEF at baseline (r=0.679, P=0.001) and at 12-month follow-up (r=0.477, P=0.039). Six months after cell administration, myocardial viability within the infarct area by 18-FDG SPECT was improved in both groups compared with baseline, but no significant difference in the BMSCs compared with control groups (4.0±0.4% 95%CI 3.1-4.9 vs. 3.2±0.5% 95%CI 2.1-4.3, P=0.237). 99mTc-sestamibi SPECT demonstrated that myocardial perfusion within the infarct area in the BMSCs did not differ from the control group (4.4±0.5% 95%CI 3.2-5.5 vs. 3.9±0.6% 95%CI 2.6-5.2, P=0.594). Similarly, LVEF after 12 and 24 months follow-up did not show any difference between the two groups. In the BMSCs group, one patient suffered a serious complication of coronary artery occlusion during the BMSCs injection procedure. CONCLUSIONS: The clinical benefits of intracoronary injection of autologous BMSCs in acute STEMI patients need further investigation and reevaluation.
RCT Entities:
BACKGROUND: Previous studies showed improvement in heart function by injecting bone marrow mesenchymal stem cells (BMSCs) after AMI. Emerging evidence suggested that both the number and function of BMSCs decline with ageing. We designed a randomized, controlled trial to further investigate the safety and efficacy of this treatment. METHODS:Patients with ST-elevation AMI undergoing successful reperfusion treatment within 12 hours were randomly assigned to receive an intracoronary infusion of BMSCs (n=21) or standard medical treatment (n=22) (the numbers of patients were limited because of the complication of coronary artery obstruction). RESULTS: There is a closely positive correlation of the number and function of BMSCs vs. the cardiac function reflected by LVEF at baseline (r=0.679, P=0.001) and at 12-month follow-up (r=0.477, P=0.039). Six months after cell administration, myocardial viability within the infarct area by 18-FDG SPECT was improved in both groups compared with baseline, but no significant difference in the BMSCs compared with control groups (4.0±0.4% 95%CI 3.1-4.9 vs. 3.2±0.5% 95%CI 2.1-4.3, P=0.237). 99mTc-sestamibi SPECT demonstrated that myocardial perfusion within the infarct area in the BMSCs did not differ from the control group (4.4±0.5% 95%CI 3.2-5.5 vs. 3.9±0.6% 95%CI 2.6-5.2, P=0.594). Similarly, LVEF after 12 and 24 months follow-up did not show any difference between the two groups. In the BMSCs group, one patient suffered a serious complication of coronary artery occlusion during the BMSCs injection procedure. CONCLUSIONS: The clinical benefits of intracoronary injection of autologous BMSCs in acute STEMI patients need further investigation and reevaluation.
Authors: Muhammad R Afzal; Anweshan Samanta; Zubair I Shah; Vinodh Jeevanantham; Ahmed Abdel-Latif; Ewa K Zuba-Surma; Buddhadeb Dawn Journal: Circ Res Date: 2015-07-09 Impact factor: 17.367
Authors: Matthew C L Keith; Xian-Liang Tang; Yukichi Tokita; Qian-Hong Li; Shahab Ghafghazi; Joseph Moore Iv; Kyung U Hong; Brandon Elmore; Alok Amraotkar; Brian L Ganzel; Kendra J Grubb; Michael P Flaherty; Gregory Hunt; Bathri Vajravelu; Marcin Wysoczynski; Roberto Bolli Journal: PLoS One Date: 2015-04-23 Impact factor: 3.240
Authors: Lian R Gao; Yu Chen; Ning K Zhang; Xi L Yang; Hui L Liu; Zhi G Wang; Xiao Y Yan; Yu Wang; Zhi M Zhu; Tian C Li; Li H Wang; Hai Y Chen; Yun D Chen; Chao L Huang; Peng Qu; Chen Yao; Bin Wang; Guang H Chen; Zhong M Wang; Zhao Y Xu; Jing Bai; Di Lu; Yan H Shen; Feng Guo; Mu Y Liu; Yong Yang; Yan C Ding; Ye Yang; Hai T Tian; Qing A Ding; Li N Li; Xin C Yang; Xiang Hu Journal: BMC Med Date: 2015-07-10 Impact factor: 8.775
Authors: Piotr Musialek; Adam Mazurek; Danuta Jarocha; Lukasz Tekieli; Wojciech Szot; Magdalena Kostkiewicz; R Pawel Banys; Malgorzata Urbanczyk; Andrzej Kadzielski; Mariusz Trystula; Jacek Kijowski; Krzysztof Zmudka; Piotr Podolec; Marcin Majka Journal: Postepy Kardiol Interwencyjnej Date: 2015-06-22 Impact factor: 1.426