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European Heart Journal Advance Access published online on June 9, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp220
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

Long-term myocardial functional improvement after autologous bone marrow mononuclear cells transplantation in patients with ST-segment elevation myocardial infarction: 4 years follow-up{ddagger}

Feng Cao1,{dagger},*, Dongdong Sun1,{dagger}, Chengxiang Li1,{dagger}, Kazim Narsinh2, Li Zhao1, Xue Li1, Xuyang Feng1, Jun Zhang3, Yunyan Duan3, Jing Wang4, Dingjing Liu4 and Haichang Wang1,*

1 Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
3 Department of Ultrasound, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
4 Department of Nuclear medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
2 Department of Medicine, University of California, San Diego, CA, USA

Received 2 November 2008; revised 15 April 2009; accepted 4 May 2009 * Corresponding author. Tel: +86 29 84773464, Fax: +86 29 84771024, Email: wind8828{at}gmail.com (F.C.), Tel: +86 29 84775183, Fax: +86 29 84773469, Email: wanghc{at}fmmu.edu.cn (H.W.)

Aims: To evaluate the safety profile and efficacy of bone marrow mononuclear cells (BMMNC) transplantation for ST-segment elevation myocardial infarction (STEMI) by assessing patients and their left ventricular function at up to 4 years follow-up.

Methods and results: Eighty-six patients with STEMI who had successfully undergone percutaneous coronary intervention (PCI) were randomized to receive intracoronary injection of BMMNC (n = 41) or saline (n = 45). Left ventricular ejection fraction, as evaluated by UCG, was markedly improved at 6 months (0.484 ± 0.5 vs. 0.457 ± 0.6, P = 0.001), 1 year (0.482 ± 0.7 vs. 0.446 ± 0.6, P < 0.001), and 4 years (0.505 ± 0.8 vs. 0.464 ± 0.8, P < 0.001) after BMMNC transplant when compared with control group. However, the current cell therapy did not improve the myocardial viability of the infarcted area as assessed by single-photon emission computed tomography analysis at 4 years post-transplant (0.263 ± 0.007 in BMMNC group vs. 0.281 ± 0.008 in control group, P = 0.10). During the follow-up period, one control group case (2.2%) of in-stent restenosis was confirmed by coronary angiography and underwent repeat PCI. Also during follow-up, one death (2.2%) occurred in the control group, and one patient (2.4%) in the BMMNC group had transient acute heart failure.

Conclusion: This study indicates that intracoronary delivery of autologous BMMNC is safe and feasible for STEMI patients who have undergone PCI, and can lead to long-term improvement in myocardial function.

Key Words: Bone marrow mononuclear cells • Cell therapy • ST-segment elevation myocardial infarction • Percutaneous coronary intervention • Left ventricular function

{dagger} The first three authors contributed equally to the study.

{ddagger} This work was performed in Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China


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