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A critical challenge: Dosage-related efficacy and acute complication intracoronary injection of autologous bone marrow mesenchymal stem cells in acute myocardial infarction
- Source :
- International Journal of Cardiology. 168:3191-3199
- Publication Year :
- 2013
- Publisher :
- Elsevier BV, 2013.
-
Abstract
- 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 12hours 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 24months 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.
- Subjects :
- Male
Cardiac function curve
medicine.medical_specialty
Time Factors
Myocardial Infarction
Mesenchymal Stem Cell Transplantation
Transplantation, Autologous
law.invention
stomatognathic system
Randomized controlled trial
law
Internal medicine
medicine
Humans
Single-Blind Method
Myocardial infarction
Intraoperative Complications
Radionuclide Imaging
Ejection fraction
Dose-Response Relationship, Drug
business.industry
Mesenchymal stem cell
Middle Aged
medicine.disease
Treatment Outcome
medicine.anatomical_structure
Injections, Intra-Arterial
Cardiology
Female
Cardiology and Cardiovascular Medicine
Complication
business
Perfusion
Artery
Subjects
Details
- ISSN :
- 01675273
- Volume :
- 168
- Database :
- OpenAIRE
- Journal :
- International Journal of Cardiology
- Accession number :
- edsair.doi.dedup.....eaf68ddc17d5ce6e0bfbb69a15d384db
- Full Text :
- https://doi.org/10.1016/j.ijcard.2013.04.112