European Heart Journal Advance Access originally published online on November 10, 2006
European Heart Journal
2006 27(23):2775-2783; doi:10.1093/eurheartj/ehl388
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Improved clinical outcome after intracoronary administration of bone-marrow-derived progenitor cells in acute myocardial infarction: final 1-year results of the REPAIR-AMI trial
1 J. W. Goethe Universität Frankfurt, Med. Klinik III, Abt. Kardiologie, Theodor-Stern-Kai 7, 60590 Frankfurt a. M., Germany
2 Universität Leipzig, Herzzentrum, Abt. Kardiologie, Strümpellstr. 39, 04289 Leipzig, Germany
3 Kerckhoff-Klinik, Abt. für Kardiologie, Beneckestr. 2-8, 61231 Bad Nauheim, Germany
4 Zentralklinikum Suhl, Klinik für Innere Medizin I, Albert-Schweitzer-Str. 2, 985527 Suhl, Germany
5 Universitätsklinikum Giessen-Marburg, Standort Giessen, Zentrum für Innere Medizin, Abt. Kardiologie/Angiologie, Klinikstrasse 36, D-35392 Gießen, Germany
6 Zentralklinik Bad Berka, Klinik für Kardiologie, Robert Koch Allee 9, 99437 Bad Berka, Germany
7 Universitätsspital Zürich, Abt. Kardiologie, Rämistrasse 100, 8091 Zürich, Switzerland
8 Hamburg University Cardiovascular Center, Praxis Prof. Mathey, Prof. Schofer & Partner, Othmarscher Kirchenweg 168, 22763 Hamburg, Germany
9 Universitätsklinikum Mannheim, I. Med. Klinik/Kardiologie, Angiologie/Pneumologie, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim, Germany
10 Universitätskliniken des Saarlandes, Med. Klinik und Poliklinik/III, Kirrberger Straße, 66421 Homburg/Saar, Germany
11 Kardiologisches Centrum, Rotes-Kreuz-Krankenhaus, Pfingstweidstraße 11, 60316 Frankfurt a. M., Germany
12 Klinikum Kassel, Medizinische Klinik II, Kardiologie, Mönchebergstraße 41-43, 34125 Kassel, Germany
13 Ruhruniversität Bochum, BG Klinik, Klinik für Kardiologie und Angiologie, Gudrunstr. 56, 44791 Bochum, Germany
14 Herzzentrum Ludwigshafen, Abt. Kardiologie/Pneumologie, Bremser Straße 79, 67063 Ludwigshafen, Germany
15 Institut für Transfusionsmedizin und Immunhämatologie, Blutspendedienst DRK, Sandhofstr. 1, D-60528 Frankfurt a. M., Germany
16 J. W. Goethe Universität Frankfurt, Med. Klinik III, Molekulare Kardiologie, Theodor-Stern-Kai 7, 60590 Frankfurt a. M., Germany
Received 12 October 2006; revised 30 October 2006; accepted 31 October 2006; online publish-ahead-of-print 10 November 2006.
* Corresponding author. Tel: +49 69 6301 5789; fax: +49 69 6301 6374. E-mail address: zeiher{at}em.uni-frankfurt.de
Aims To investigate the clinical outcome after intracoronary administration of autologous progenitor cells in patients with acute myocardial infarction (AMI).
Methods and results Using a double-blind, placebo-controlled multicentre trial design, we randomized 204 patients with successfully reperfused AMI to receive intracoronary infusion of bone-marrow-derived progenitor cells (BMCs) or placebo medium into the infarct artery 3–7 days after successful infarct reperfusion therapy. At 12 months, the pre-specified cumulative endpoint of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (P=0.009). Likewise, the combined endpoint death, recurrence of myocardial infarction, and rehospitalization for heart failure was significantly (P=0.006) reduced in patients receiving intracoronary BMC administration. Intracoronary administration of BMC remained a significant predictor of a favourable clinical outcome by Cox regression analysis, adjusting for classical predictors of poor outcome after AMI.
Conclusion Intracoronary administration of BMCs is associated with a significant reduction of the occurrence of major adverse cardiovascular events after AMI. Large-scale studies are warranted to confirm the effects of BMC administration on mortality and morbidity in patients with AMIs.
Key Words: Myocardial infarction • Prognosis • Cells • Catheterization
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