BONE MARROW CELL TRANSFER AFTER MI

Intracoronary infusion of bone marrow cells after ST-segment-elevation MI--Hope is that it may help regenerate myocardium and stimulate neovascularization

1. In a study in 204 pts with STEMI s/p successful stent reperfusion but with LVEF < 45% randomized to intracoronary bone marrow cells vs. placebo 3-7d later, at 1y, the active-tx group had sig. lower incidence of (death or MI) (2% vs. 10%)  ("Reinfusion of enriched Progenitor Cells and Infarct Remodeling in Acute Myocardial Infarction Trial" ("REPAIR-AMI") Trial; NEJM:355:1210, 2006--JW)
2. In a study in 101 pts s/p anterior-wall STEMI s/p successful stening randomized to BMC infusion vs. no infusion 4-8d later; at 6mos there were no sig. diffs. in LVEF or infarct size ("Autologous Stem-Cell Transplantation in Acute Myocardial Infarction" (ASTAMI") Trial; NEJM 355:1199, 2006--JW)
3. In a study in 75 pts with h/o MI at least 3mos previously (mean was 80mos previously) and a patent infarct-related artery randomized to bone marrow cell transfer, circulating progenitor cells, or no infusion, BMC but not CPC transfer was associated with sig. increase in LVEF (mean increase 2.9%) at 3mos (NEJM 355:1222, 2006--JW)