Abstract

Objective We evaluated the effects of stem cell therapy on the coronary vasculature in patients with acute myocardial infarction who underwent peripheral blood stem cells (PBSCs) therapy in MAGIC Cell-3-DES study.

Methods Among 50 patients with acute myocardial infarction who received either sirolimus-eluting stent or paclitaxel-eluting stent implantation for the culprit lesion, we analyzed intravascular ultrasound in 36 patients (cell infusion: n=19 and control: n=17). In the cell infusion group, PBSCs mobilized by granulocyte-colony stimulating factor were delivered via intracoronary infusion into infarcted myocardium. We evaluated proximal and distal reference segments, and stented segments with intravascular ultrasound at immediate post-intervention and 6 month follow-up, respectively.

Results In the proximal and distal reference segments, the serial changes of lumen area, vessel area, and plaque plus media area were not significantly different between the cell infusion and the control groups. Within stented segments, mean neointimal area was similar between the two groups (cell infusion: 0.2 i3/4 0.5mm² vs. control: 0.3 i3/4 0.4mm², p>0.05). However, there was a significant increase in mean peri-stent area of stented segment in the cell infusion group compared to the control group (0.7 i3/4 1.4mm² vs. -0.1 i3/4 1.2mm², p<0.05). This difference mainly came from paclitaxel-eluting stent implanted patients.

Conclusion Intracoronary infusion of the mobilized PBSCs with G-CSF does not aggravate de novo atherosclerotic lesion and neointimal hyperplasia with DES implantation. However, it may induce peri-stent tissue growth at stented segment especially in patients receiving PES. Its clinical significance needs to be evaluated with long term follow up.