Guillaume Lamirault1, Elodie de Bock2, Véronique Sébille2,3, Béatrice Delasalle4, Jérôme Roncalli5, Sophie Susen6, Christophe Piot7, Jean-Noël Trochu1, Emmanuel Teiger8, Yannick Neuder9, Thierry Le Tourneau1, Alain Manrique10, Jean-Benoît Hardouin2,3, Patricia Lemarchand11. 1. INSERM, UMR1087, CNRS, UMR 6291, l'institut du thorax, Clinique cardiologique, CIC-thorax, Université de Nantes, CHU de Nantes, Nantes, 44000, France. 2. EA4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces REsearch", Université de Nantes, Nantes, France. 3. Plateforme méthodologie et biostatistique, CHU de Nantes, Nantes, France. 4. INSERM, UMR1087, CNRS, UMR 6291, l'institut du thorax, CIC-thorax, Université de Nantes, CHU de Nantes, Nantes, 44000, France. 5. Service de Cardiologie A, CIC-Biothérapies, I2MC, INSERM 1048, CHU de Toulouse, Toulouse, France. 6. Department of Hematology and Transfusion, Lille University Hospital, EA 2693, Lille-II-University, Lille, France. 7. Cardiologie interventionnelle, Clinique du Millénaire, 34000, Montpellier, France. 8. Assistance Publique-Hôpitaux de Paris, Fédération de Cardiologie et Centre d'Investigation Clinique 1430, Hôpitaux Universitaires Henri Mondor, 94010, Créteil, France. 9. Pole Thorax et Vaisseaux, CHU de Grenoble, La Tronche, France. 10. EA4650, Department of Imaging, CHU de Caen, GIP CYCERON, Université de Caen Basse-Normandie, Caen, France. 11. INSERM, UMR1087, CNRS, UMR 6291, l'institut du thorax, CIC-thorax, Université de Nantes, CHU de Nantes, Nantes, 44000, France. patricia.lemarchand@univ-nantes.fr.
Abstract
PURPOSE:Cardiac cell therapy is a promising treatment for acute myocardial infarction (AMI), leading to cardiac function improvement. However, whether it translates into quality of life (QoL) improvement is unclear. We hypothesized that administration of bone marrow cells (BMC) to patients with AMI improves QoL. METHODS: In the multicenter BONAMI trial (NCT00200707), patients with reperfused AMI and decreased myocardial viability were randomized to intracoronary autologous BMC infusion (n = 52) or state-of-the-art therapy (n = 49). QoL data, derived from the Minnesota Living with Heart Failure questionnaire (MLHFQ), were obtained 1, 3, and 12 months after AMI and analyzed using a Rasch-family model. RESULTS: Using this model, QoL improved over time in the BMC group (p = 0.025) but not in the control group. Furthermore, the BMC-group patients displayed a better QoL than the control-group patients at 3 and 12 months post-AMI (p = 0.034 and p = 0.003, respectively). These findings were not detected when analyzing MLHFQ data using a standard method. Cardiac function, myocardial viability, mortality, and number of major adverse cardiac events did not differ between treatment groups. CONCLUSION: Our results suggest that BMC therapy can improve QoL, stressing the need for confirmation trials and for systematic QoL assessment in cardiac cell therapy trials .
RCT Entities:
PURPOSE: Cardiac cell therapy is a promising treatment for acute myocardial infarction (AMI), leading to cardiac function improvement. However, whether it translates into quality of life (QoL) improvement is unclear. We hypothesized that administration of bone marrow cells (BMC) to patients with AMI improves QoL. METHODS: In the multicenter BONAMI trial (NCT00200707), patients with reperfused AMI and decreased myocardial viability were randomized to intracoronary autologous BMC infusion (n = 52) or state-of-the-art therapy (n = 49). QoL data, derived from the Minnesota Living with Heart Failure questionnaire (MLHFQ), were obtained 1, 3, and 12 months after AMI and analyzed using a Rasch-family model. RESULTS: Using this model, QoL improved over time in the BMC group (p = 0.025) but not in the control group. Furthermore, the BMC-group patients displayed a better QoL than the control-group patients at 3 and 12 months post-AMI (p = 0.034 and p = 0.003, respectively). These findings were not detected when analyzing MLHFQ data using a standard method. Cardiac function, myocardial viability, mortality, and number of major adverse cardiac events did not differ between treatment groups. CONCLUSION: Our results suggest that BMC therapy can improve QoL, stressing the need for confirmation trials and for systematic QoL assessment in cardiac cell therapy trials .
Entities:
Keywords:
Acute myocardial infarction; Bone marrow mononuclear cells; Cardiac cell therapy; Heart failure; Quality of life; Rasch-family model
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