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European Heart Journal Advance Access published online on October 9, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn436
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Effects of intracoronary injection of mononuclear bone marrow cells on left ventricular function, arrhythmia risk profile, and restenosis after thrombolytic therapy of acute myocardial infarction

Heikki V. Huikuri1,*, Kari Kervinen1, Matti Niemelä1, Kari Ylitalo1, Marjaana Säily1, Pirjo Koistinen1, Eeva-Riitta Savolainen2, Heikki Ukkonen3, Mikko Pietilä3, Juhani K.E. Airaksinen3, Juhani Knuuti4, Timo H. Mäkikallio1,{dagger} for the FINCELL Investigators

1 Department of Internal Medicine, University of Oulu, PO Box 5000 (Kajaanintie 50), FIN-90014 Oulu, Finland
2 Department of Clinical Chemistry, University of Oulu, Oulu, Finland
3 Department of Internal Medicine, Turku, Finland
4 Turku PET-centre, Turku, Finland

Received 16 April 2008; revised 28 August 2008; accepted 12 September 2008.

* Corresponding author. Tel: +358 8 315 4108, Fax: +358 315 5599, Email: heikki.huikuri{at}oulu.fi

Aims: To assess the efficacy and safety of bone marrow cell (BMC) therapy after thrombolytic therapy of an acute ST-elevation myocardial infarction (STEMI).

Methods and results: Patients with STEMI treated with thrombolysis followed by percutaneous coronary intervention (PCI) 2–6 days after STEMI were randomly assigned to receive intracoronary BMCs (n = 40) or placebo medium (n = 40), collected and prepared 3–6 h prior PCI and injected into the infarct artery immediately after stenting. Efficacy was assessed by the measurement of global left ventricular ejection fraction (LVEF) by left ventricular angiography and 2-D echocardiography, and safety by measuring arrhythmia risk variables and restenosis of the stented vessel by intravascular ultrasound. At 6 months, BMC group had a greater absolute increase of global LVEF than placebo group, measured either by angiography (mean ± SD increase 7.1 ± 12.3 vs. 1.2 ± 11.5%, P = 0.05) or by 2-D echocardiography (mean ± SD increase 4.0 ± 11.2 vs. –1.4 ± 10.2%, P = 0.03). No differences were observed between the groups in the adverse clinical events, arrhythmia risk variables, or the minimal lumen diameter of the stented coronary lesion.

Conclusion: Intracoronary BMC therapy is associated with an improvement of global LVEF and neutral effects on arrhythmia risk profile and restenosis of the stented coronary lesions in patients after thrombolytic therapy of STEMI.

Key Words: Stem cells • Acute coronary syndrome • Arrhythmias • Restenosis

{dagger} Members of the FINnish study of autologous bone marrow-derived stem CELLs in acute myocardial infarction (FINCELL) group are listed in the Appendix.

ClinicalTrials.gov number, NCT00363324 [ClinicalTrials.gov] .


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