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Intracoronary infusion of autologous mononuclear bone marrow cells in patients with acute myocardial infarction treated with primary PCI: Pilot study of the multicenter HEBE trial
Author(s) -
Hirsch Alexander,
Nijveldt Robin,
van der Vleuten Pieter A.,
Tio René A.,
van der Giessen Willem J.,
Marques Koen M.J.,
Doevendans Pieter A.,
Waltenberger Johannes,
ten Berg Jurrien M.,
Aengevaeren Wim R.M.,
Biemond Bart J.,
Tijssen Jan G.P.,
van Rossum Albert C.,
Piek Jan J.,
Zijlstra Felix
Publication year - 2008
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.21337
Subject(s) - medicine , interquartile range , myocardial infarction , conventional pci , ejection fraction , cardiology , bone marrow , multicenter trial , surgery , randomized controlled trial , heart failure , multicenter study
Abstract Objective : This study was a pilot trial to determine safety and feasibility of intracoronary infusion of mononuclear bone marrow cells (MBMC) in patients with acute myocardial infarction (MI). Background : Studies reporting the effect of MBMC therapy on improvement of left ventricular (LV) function have shown variable results. The HEBE trial is a large multicenter, randomized trial that currently enrolls patients. Prior to this trial we performed a pilot study. Methods : Twenty‐six patients with a first acute MI were prospectively enrolled in eight centers. Bone marrow aspiration was performed at a median of 6 days after primary PCI (interquartile range, 5–7 days). MBMC were isolated by gradient centrifugation and were infused intracoronary the same day. All patients underwent magnetic resonance imaging before cell infusion and after 4 months. Clinical events were assessed up to 12 months. Results : Within 10 hr after bone marrow aspiration, 246 ± 133 × 10 6 MBMC were infused, of which 3.9 ± 2.3 × 10 6 cells were CD34 + . In one patient, this procedure was complicated by local dissection. LV ejection fraction significantly increased from 45.0 ± 6.3% to 47.2 ± 6.5% ( P = 0.03). Systolic wall thickening in dysfunctional segments at baseline improved with 0.9 ± 0.7 mm ( P < 0.001). Infarct size decreased 37% from 17.8 ± 8.2 to 11.2 ± 4.2 gram ( P < 0.001). During 12‐month follow‐up, 3 additional revascularizations were performed and an ICD was implanted in one patient, 3 weeks after PCI. Conclusion : In patients with acute MI, intracoronary infusion of MBMC is safe in a multicenter setting. At 4‐month follow‐up, a modest increase in global and regional LV function was observed, with a concomitant decrease in infarct size. © 2008 Wiley‐Liss, Inc.