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Pilot study to evaluate the safety and feasibility of intracoronary CD133 + and CD133 − CD34 + cell therapy in patients with nonviable anterior myocardial infarction
Author(s) -
Manginas Athanassios,
Goussetis Evgenios,
Koutelou Maria,
Karatasakis George,
Peristeri Ioulia,
Theodorakos Athanassios,
Leontiadis Evangelos,
Plessas Nikolaos,
Theodosaki Maria,
Graphakos Stelios,
Cokkinos Dennis V
Publication year - 2007
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21023
Subject(s) - medicine , myocardial infarction , nuclear medicine
Objectives : The long‐term effect of intracoronary infusion of progenitor cells in patients with chronic ischemic cardiomyopathy. Background : Bone marrow stem‐cell administration in patients with myocardial infarction improved myocardial performance and in some studies contributed to favorable left ventricular remodeling. Methods : We report on the results of a pilot, single center, controlled safety, and feasibility study, including 24 patients with old, nonviable anterior myocardial infarction. Twelve patients underwent intracoronary administration of selected CD133 + and CD133 − CD34 + progenitor cells and 12 were followed up on medical therapy. Left ventricular volumes and ejection fraction, at rest and during low‐dose dobutamine, and myocardial viability, using TL‐201 reinjection scintigraphy, were analyzed at baseline and long‐term follow‐up. Results : Patients in the treatment group experienced a sustained decrease in left ventricular end‐diastolic and end‐systolic resting volumes ( P = 0.008 and P = 0.002, respectively), as well as an improvement in global ejection fraction at rest [from (27.2 ± 6.8)% to (29.7 ± 7.3)%, P = 0.016]. Segmental anterior and apical wall perfusion, during TL‐201 reinjection, were similarly improved ( P = 0.005 and P << 0.001, respectively). One patient developed restenosis at the cell delivery site and one progression of atherosclerosis. During 28.0 ± 8.7 months of clinical follow‐up, only one patient experienced deterioration of heart failure. In the control group, we observed stability in the perfusion defect and deterioration in end‐diastolic and end‐systolic volumes ( P = 0.002 and P = 0.003, respectively) and a nonsignificant decrease in ejection fraction ( P = 0.11). Conclusion : Intracoronary infusion of selected CD133 + and CD133 − CD34 + progenitor cells to a previously infarcted and nonviable anterior wall is safe, and results in sustained improvement in segmental myocardial perfusion and in favorable left ventricular remodeling. © 2007 Wiley‐Liss, Inc.