Cell Therapy Following Acute Myocardial Infarction: Do Recent Clinical Trial Results Still Warrant Enthusiasm?

With advancements in pharmacologic and mechanical reperfusion strategies, survival following myocardial infarction (M I) has greatly improved. Strategies to shorten the time from symptom-onset to treatment in M I have been the focus of considerable study. However, even when revasculariza- tion therapy is initiated expeditiously, many patients fail to have significant recovery of cardiac func- tion. Therefore, a number of preclinical and clinical studies have examined the use of cell therapy to restore cardiac function post-M I. Preclinical studies suggest that various types of circulating or bone marrow-derived cells can reduce infarct size, stimulate angiogenesis, attenuate remodeling, and improve myocardial contractility following M I. 1 Based on these encouraging results, clinical trials have been initiated to assess the safety and efficacy of these approaches in humans. In a previous issue of Cardiology Rounds, the early safety trials of cell therapy were discussed. In this issue, we focus on recent efficacy trials involving intracoronary catheter-based cell delivery or bone marrow (BM) cell mobilization with granulocyte colony-stimulating factor (G-CSF).