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Efficacy of emergent transcatheter transplantation of stem cells for treatment of acute myocardial infarction (TCT-STAMI)

Abstract

Objective: To study whether emergent intracoronary autologous bone marrow cell transplantation (BMT) is applicable for the treatment of acute myocardial infarction (AMI).

Methods: 20 patients admitted within 24 h after the onset of a first AMI were randomly allocated to receive intracoronary autologous BMT (n  =  10) or bone marrow supernatant (controls, n  =  10) immediately after primary percutaneous coronary intervention. Left ventricular ejection fraction (LVEF), left ventricular end diastolic internal diameter (LVDd) and myocardial perfusion defect scores were examined respectively by echocardiography and single-photon emission computed tomography at one week and six months after AMI.

Results: From one week to six months after AMI, LVEF was enhanced from mean 53.8 (SD 9.2)% to 58.6 (9.9)% (p < 0.05) in the BMT group but was unchanged in the control group (58.2 (7.5)% v 56.3 (3.5)%, p > 0.05); LVDd remained unchanged (52.5 (2.8) v 52.1 (3.2) mm, p > 0.05) in the BMT group but was significantly enlarged in the control group (50.4 (6.0) v 55.2 (7.1) mm, p < 0.05). Additionally, myocardial perfusion defect scores decreased from 21 (11) to 13 (10) (p < 0.01) in the BMT group but were unchanged in the control group (20 (14) v 17 (15), p > 0.05).

Conclusion: Emergent intracoronary transplantation of bone marrow mononuclear cells after AMI is practicable, and it improved cardiac function, prevented myocardial remodelling and increased myocardial perfusion at six months’ follow up.

  • AMI, acute myocardial infarction
  • BMCs, bond marrow stem cells
  • BM-MNCs, bone marrow mononuclear cells
  • BMT, bone marrow cell transplantation
  • BOOST, Bone Marrow Transfer to Enhance ST Elevation Infarct Regeneration
  • FACS, fluorescence-activated cell sorter
  • FITC, fluorescein isothiocyanate
  • LVDd, left ventricular end diastolic internal diameter
  • LVEF, left ventricular ejection fraction
  • PCI, percutaneous coronary intervention
  • SPECT, single-photon emission computed tomography
  • TCT-STAMI, Emergent Transcatheter Transplantation of Stem Cells for Treatment of Acute Myocardial Infarction
  • VEGF, vascular endothelial growth factor

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