Author:
Zhang Runfeng,Yu Jiang,Zhang Ningkun,Li Wensong,Wang Jisheng,Cai Guocai,Chen Yu,Yang Yong,Liu Zhenhong
Abstract
Abstract
Objective
Our aim was to evaluate the efficacy and safety of intracoronary autologous bone marrow mesenchymal stem cell (BM-MSC) transplantation in patients with ST-segment elevation myocardial infarction (STEMI).
Methods
In this randomized, single-blind, controlled trial, patients with STEMI (aged 39–76 years) were enrolled at 6 centers in Beijing (The People’s Liberation Army Navy General Hospital, Beijing Armed Police General Hospital, Chinese People’s Liberation Army General Hospital, Beijing Huaxin Hospital, Beijing Tongren Hospital, Beijing Chaoyang Hospital West Hospital). All patients underwent optimum medical treatment and percutaneous coronary intervention and were randomly assigned in a 1:1 ratio to BM-MSC group or control group. The primary endpoint was the change of myocardial viability at the 6th month’s follow-up and left ventricular (LV) function at the 12th month’s follow-up. The secondary endpoints were the incidence of cardiovascular event, total mortality, and adverse event during the 12 months’ follow-up. The myocardial viability assessed by single-photon emission computed tomography (SPECT). The left ventricular ejection fraction (LVEF) was used to assess LV function. All patients underwent dynamic ECG and laboratory evaluations. This trial is registered with ClinicalTrails.gov, number NCT04421274.
Results
Between March 2008 and July 2010, 43 patients who had underwent optimum medical treatment and successful percutaneous coronary intervention were randomly assigned to BM-MSC group (n = 21) or control group (n = 22) and followed-up for 12 months. At the 6th month’s follow-up, there was no significant improvement in myocardial activity in the BM-MSC group before and after transplantation. Meanwhile, there was no statistically significant difference between the two groups in the change of myocardial perfusion defect index (p = 0.37) and myocardial metabolic defect index (p = 0.90). The LVEF increased from baseline to 12 months in the BM-MSC group and control group (mean baseline-adjusted BM-MSC treatment differences in LVEF 4.8% (SD 9.0) and mean baseline-adjusted control group treatment differences in LVEF 5.8% (SD 6.04)). However, there was no statistically significant difference between the two groups in the change of the LVEF (p = 0.23). We noticed that during the 12 months’ follow-up, except for one death and one coronary microvascular embolism in the BM-MSC group, no other events occurred and alanine transaminase (ALT) and C-reactive protein (CRP) in BM-MSC group were significantly lower than that in the control group.
Conclusions
The present study may have many methodological limitations, and within those limitations, we did not identify that intracoronary transfer of autologous BM-MSCs could largely promote the recovery of LV function and myocardial viability after acute myocardial infarction.
Publisher
Springer Science and Business Media LLC
Subject
Cell Biology,Biochemistry, Genetics and Molecular Biology (miscellaneous),Molecular Medicine,Medicine (miscellaneous)
Reference44 articles.
1. Li Y, Pfeffer MA, Solomon SD, Weinfurt KP, et al. Impact of cardiovascular events on change in quality of life and utilities in patients after myocardial infarction: a VALIANT study (valsartan in acute myocardial infarction). JACC Heart Fail. 2014;2:159–65.
2. Lavall MC, Bagatini MD, Thomé GR, et al. Extracellular hydrolysis of adenine nucleotides and nucleoside adenosine is higher in patients with ST elevation than non-ST elevation in acute myocardial infarction. Clin Lab. 2015;61(7):761–7.
3. Kook HY, Jeong MH, Oh S, et al. Current trend of acute myocardial infarction in Korea (from the Korea Acute Myocardial Infarction Registry from 2006 to 2013). Am J Cardiol. 2014;114(12):1817–22.
4. Gnavi R, Rusciani R, Dalmasso M, et al. Gender, socioeconomic position, revascularization procedures and mortality in patients presenting with STEMI and NSTEMI in the era of primary PCI. Differences or inequities? Int J Cardiol. 2014;176(3):724–30.
5. Kloner RA, Dai W, Hale SL, et al. Approaches to improving cardiac structure and function during and after an acute myocardial infarction:acute and chronic phases. J Cardiovasc Pharmacol Ther. 2016;21(4):363–7.
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