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Previous Volume 355:1210-1221 September 21, 2006 Number 12 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Perspective by Schwartz, R. S. Editorial by Rosenzweig, A. Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited E-mail When Letters Appear PubMed Citation

ABSTRACT

Background Pilot trials suggest that the intracoronary administration of autologous progenitor cells may improve left ventricular function after acute myocardial infarction.

Methods In a multicenter trial, we randomly assigned 204 patients with acute myocardial infarction to receive an intracoronary infusion of progenitor cells derived from bone marrow (BMC) or placebo medium into the infarct artery 3 to 7 days after successful reperfusion therapy.

Results At 4 months, the absolute improvement in the global left ventricular ejection fraction (LVEF) was significantly greater in the BMC group than in the placebo group (mean [±SD] increase, 5.5±7.3% vs. 3.0±6.5%; P=0.01). Patients with a baseline LVEF at or below the median value of 48.9% derived the most benefit (absolute improvement in LVEF, 5.0%; 95% confidence interval, 2.0 to 8.1). At 1 year, intracoronary infusion of BMC was associated with a reduction in the prespecified combined clinical end point of death, recurrence of myocardial infarction, and any revascularization procedure (P=0.01).

Conclusions Intracoronary administration of BMC is associated with improved recovery of left ventricular contractile function in patients with acute myocardial infarction. Large-scale studies are warranted to examine the potential effects of progenitor-cell administration on morbidity and mortality. (ClinicalTrials.gov number, NCT00279175 [ClinicalTrials.gov] .)

Source Information

From the Department of Internal Medicine III, Johann Wolfgang Goethe University, Frankfurt (V.S., B.A., S.D., A.M.Z.); the Department of Cardiology, Herzzentrum Leipzig, Leipzig (S.E., R.H.); the Department of Cardiology, Kerckhoff Klinik, Bad Nauheim (A.E., C.W.H.); the Department of Internal Medicine, Zentralklinikum Suhl, Suhl (W.H.); the Department of Cardiology, Universitätsklinikum Giessen, Giessen (H.H.); the Department of Cardiology, Zentralklinikum, Bad Berka (J.Y.); the Hamburg University Cardiovascular Center, Hamburg (D.G.M.); the Department of Cardiology, Universitätsklinikum, Mannheim (T.S.); and the Institute for Transfusion Medicine and Immunohematology, Red Cross Blood Donor Service Baden–Württemberg–Hessen, Frankfurt (T.T.) — all in Germany; and the Department of Cardiology, Universitätsspital, Zurich, Switzerland (R.C.).

Address reprint requests to Dr. Zeiher at the Department of Internal Medicine III, J.W. Goethe University, Theodor-Stern-Kai 7, D-60590 Frankfurt, Germany, or at zeiher{at}em.uni-frankfurt.de.

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