Circulation. 2006;113:1287-1294
Published online before print March 6, 2006, doi: 10.1161/CIRCULATIONAHA.105.575118
Published online before print March 6, 2006, doi: 10.1161/CIRCULATIONAHA.105.575118
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(Circulation. 2006;113:1287-1294.)
© 2006 American Heart Association, Inc.
Coronary Heart Disease |
Intracoronary Bone Marrow Cell Transfer After Myocardial Infarction
Eighteen Months’ Follow-Up Data From the Randomized, Controlled BOOST (BOne marrOw transfer to enhance ST-elevation infarct regeneration) Trial
From the Departments of Cardiology and Angiology (G.P.M., K.C.W., J.S., P.L., S.F., A.S., H.D.), Diagnostic Radiology (J.L.), Biometrics (H.H.), and Hematology and Oncology (L.A., B.H., A.G.), Hannover Medical School, Hannover, Germany.
Correspondence to Prof Dr Helmut Drexler, Abt. Kardiologie und Angiologie, Medizinische Hochschule Hannover, Carl-Neuberg Straße 1, 30625 Hannover, Germany. E-mail drexler.helmut{at}mh-hannover.de
Received July 14, 2005; revision received December 15, 2005; accepted January 9, 2006.
Background— Intracoronary transfer of autologous bone marrow cells (BMCs) may enhance recovery of left ventricular (LV) function in patients after acute myocardial infarction (AMI). However, clinical studies addressing the effects of BMCs after AMI have covered only limited time frames ranging from 3 to 6 months. The critical question of whether BMC transfer can have a sustained impact on LV function remains unanswered.
Methods and Results– After percutaneous coronary intervention with stent implantation (PCI) of the infarct-related artery, 60 patients were randomized 1:1 to a control group with optimal postinfarction therapy and a BMC transfer group that also received an intracoronary BMC infusion 4.8±1.3 days after PCI. Cardiac MRI was performed 3.5±1.5 days, 6±1 months, and 18±6 months after PCI. BMC transfer was not associated with adverse clinical events. In the control group, mean global LV ejection fraction increased by 0.7 and 3.1 percentage points after 6 and 18 months, respectively. LV ejection fraction in the BMC transfer group increased by 6.7 and 5.9 percentage points. The difference in LVEF improvement between groups was significant after 6 months but not after 18 months (P=0.27). The speed of LV ejection fraction recovery over the course of 18 months was significantly higher in the BMC transfer group (P=0.001).
Conclusions– In this study, a single dose of intracoronary BMCs did not provide long-term benefit on LV systolic function after AMI compared with a randomized control group; however, the study suggests an acceleration of LV ejection fraction recovery after AMI by BMC therapy.
CLINICAL PERSPECTIVE
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S. R. Dixon, C. L. Grines, and W. W. O'Neill The Year in Interventional Cardiology J. Am. Coll. Cardiol., July 17, 2007; 50(3): 270 - 285. [Full Text] [PDF]
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 H.-F. Tse and C.-P. Lau Therapeutic Angiogenesis With Bone Marrow--Derived Stem Cells Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2007; 12(2): 89 - 97. [Abstract] [PDF]
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 A. Abdel-Latif, R. Bolli, I. M. Tleyjeh, V. M. Montori, E. C. Perin, C. A. Hornung, E. K. Zuba-Surma, M. Al-Mallah, and B. Dawn Adult Bone Marrow-Derived Cells for Cardiac Repair: A Systematic Review and Meta-analysis Arch Intern Med, May 28, 2007; 167(10): 989 - 997. [Abstract] [Full Text] [PDF]
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S. Fukushima, A. Varela-Carver, S. R. Coppen, K. Yamahara, L. E. Felkin, J. Lee, P. J.R. Barton, C. M.N. Terracciano, M. H. Yacoub, and K. Suzuki Direct Intramyocardial But Not Intracoronary Injection of Bone Marrow Cells Induces Ventricular Arrhythmias in a Rat Chronic Ischemic Heart Failure Model Circulation, May 1, 2007; 115(17): 2254 - 2261. [Abstract] [Full Text] [PDF]
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 D. J. Prockop and S. D. Olson Clinical trials with adult stem/progenitor cells for tissue repair: let's not overlook some essential precautions Blood, April 15, 2007; 109(8): 3147 - 3151. [Full Text] [PDF]
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S. L.M.A. Beeres, F. M. Bengel, J. Bartunek, D. E. Atsma, J. M. Hill, M. Vanderheyden, M. Penicka, M. J. Schalij, W. Wijns, and J. J. Bax Role of Imaging in Cardiac Stem Cell Therapy J. Am. Coll. Cardiol., March 20, 2007; 49(11): 1137 - 1148. [Abstract] [Full Text] [PDF]
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J. G.F. Cleland, A. P. Coletta, A. T. Abdellah, M. Nasir, N. Hobson, N. Freemantle, and A. L. Clark Clinical trials update from the American Heart Association 2006: OAT, SALT 1 and 2, MAGIC, ABCD, PABA-CHF, IMPROVE-CHF, and percutaneous mitral annuloplasty Eur J Heart Fail, January 1, 2007; 9(1): 92 - 97. [Abstract] [Full Text] [PDF]
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S. T. Wall, J. C. Walker, K. E. Healy, M. B. Ratcliffe, and J. M. Guccione Theoretical Impact of the Injection of Material Into the Myocardium: A Finite Element Model Simulation Circulation, December 12, 2006; 114(24): 2627 - 2635. [Abstract] [Full Text] [PDF]
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E. Lipsic, R. G. Schoemaker, P. van der Meer, A. A. Voors, D. J. van Veldhuisen, and W. H. van Gilst Protective Effects of Erythropoietin in Cardiac Ischemia: From Bench to Bedside J. Am. Coll. Cardiol., December 5, 2006; 48(11): 2161 - 2167. [Abstract] [Full Text] [PDF]
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 L. W. van Laake, R. Hassink, P. A. Doevendans, and C. Mummery Heart repair and stem cells J. Physiol., December 1, 2006; 577(2): 467 - 478. [Abstract] [Full Text] [PDF]
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R. Zhou, P. D. Acton, and V. A. Ferrari Imaging Stem Cells Implanted in Infarcted Myocardium J. Am. Coll. Cardiol., November 21, 2006; 48(10): 2094 - 2106. [Abstract] [Full Text] [PDF]
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M. R. Rosen Are Stem Cells Drugs?: The Regulation of Stem Cell Research and Development Circulation, October 31, 2006; 114(18): 1992 - 2000. [Abstract] [Full Text] [PDF]
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K.-L. Ang, L. Takura Shenje, L. Srinivasan, and M. Galinanes Repair of the damaged heart by bone marrow cells: from experimental evidence to clinical hope. Ann. Thorac. Surg., October 1, 2006; 82(4): 1549 - 1558. [Abstract] [Full Text] [PDF]
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 K. Lunde, S. Solheim, S. Aakhus, H. Arnesen, M. Abdelnoor, T. Egeland, K. Endresen, A. Ilebekk, A. Mangschau, J. G. Fjeld, et al. Intracoronary injection of mononuclear bone marrow cells in acute myocardial infarction. N. Engl. J. Med., September 21, 2006; 355(12): 1199 - 1209. [Abstract] [Full Text] [PDF]
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A. Rosenzweig Cardiac cell therapy--mixed results from mixed cells. N. Engl. J. Med., September 21, 2006; 355(12): 1274 - 1277. [Full Text] [PDF]
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A. J. Boyle, S. P. Schulman, and J. M. Hare Stem Cell Therapy for Cardiac Repair: Ready for the Next Step Circulation, July 25, 2006; 114(4): 339 - 352. [Full Text] [PDF]
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 No Long-Term Benefit of Post-MI Bone Marrow Cell Transfer Journal Watch Cardiology, May 11, 2006; 2006(511): 4 - 4. [Full Text]
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P. S.M., M. T., S. A., Y. H.T., C. D., K. S.A., S. V.P., W. B., L. P.S., T. S.M., et al. Leaking Capillaries and White Lung in Sepsis--Is Angiopoietin 2 the Culprit?: Excess Circulating Angiopoietin-2 May Contribute to Pulmonary Vascular Leak in Sepsis in Humans. PLoS Medicine 3: e46, 2006 J. Am. Soc. Nephrol., May 1, 2006; 17(5): 1207 - 1217. [Full Text] [PDF]
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