Stem Cell Transplantation in Patients with Acute Myocardial Infarction: a Single Center Registry

Background: Early clinical investigations indicate that an infusion of autologous bone-marrow cells into the infarct-re- lated coronary artery is feasible after acute myocardial infarction. There is increasing evidence that cell transplantation may improve the perfusion and contractile function of the ischemic myocardium. The present study reports primarily the safety of intracoronary bone marrow mononuclear cell (BMMNC) injections and secondarily the hypothesis that intracoronary injec- tions of autologous BMMNC in patients with acute myocardial infarction may have a favorable impact on tissue perfusion and contractile performance. Methods: Twelve patients with acute ST-elevation myocardial infarction of the anterior wall treated with percutaneous coronary intervention were enrolled in this prospective, nonrandomized, open-label study. Left ventricular function and number of nonviable segments were assessed with the use of echocardiography and Technetium-sestamibi single photon emission tomography respectively at baseline and after a 4-month follow-up. Results: At 4 months' follow-up, global left ventricular ejection fraction in echocardiography increased from a mean of 31.78±7.56% at baseline to 38.89±6.97% (p=0.018). Mean wall motion score in rest echocardiography was 29.5±6.67 in ba- sal and 26.75±5.44 at 4 months' follow-up (p=0.05). Nuclear perfusion imaging studies in the patients for the mean number of nonviable segments were 6.5 at baseline and 6 in 4 months' follow-up (p=0.17). Three patients were lost to follow-up and did not undergo the 4-month evaluations. Conclusion: This study is small and very preliminary. Data from large, randomized, controlled trials are needed to clarify the effect of stem-cell injection in myocardial function.