Abstract

To evaluate the long-term effects of peripheral blood stem cell therapy in myocardial infarction (MI) patients. A total of 163 patients with MI who were successfully revascularized with drug-eluting stents were enrolled and randomly assigned to four groups: acute MI (AMI) cell infusion, AMI control, old MI (OMI) cell infusion, and OMI control. We compared 5 years' clinical outcomes between the cell infusion group (57 and 22 patients with AMI and OMI, respectively) and the control (60 and 24 patients with AMI and OMI, respectively). In the time-sequence comparison from baseline to 6 and 24 months follow-up after AMI, left ventricular ejection fraction (LVEF) by cardiac magnetic resonance imaging was significantly improved in the cell infusion group (n = 57), but not in the control group (n = 60). In the between-group comparison, the difference in improvement of LVEF for 2 years after AMI did not reach statistical significance between cell infusion and control groups. Intriguingly, the major adverse cardiac events for 5 years were significantly reduced in the cell infusion group (n = 79) compared with the control (n = 84; composite of cardiac death, non-fatal MI, hospitalization for heart failure and angina, and target vessel revascularization; 22.8 vs. 39.3%, P = 0.015). Peripheral blood stem cell therapy has potential to improve long-term cardiovascular outcomes in MI patients.

Highlights

  • Recent clinical trials[1,2,3,4,5,6] have reported various favourable effects of stem cell therapy in patients with acute myocardial infarction (AMI)

  • A total of 163 patients were enrolled in this long-term follow-up study and randomized into four groups: 57 for AMI cell infusion group, 60 for AMI control, 22 for old MI (OMI) cell infusion group, and 24 for OMI control group, respectively

  • These 163 patients were composed of the patients in the MAGIC Cell-3-drug-eluting stents (DES) trial (n 1⁄4 102) whose short-term results were reported[3] and additional AMI patients (n 1⁄4 61) in the extension study

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Summary

Introduction

Recent clinical trials[1,2,3,4,5,6] have reported various favourable effects of stem cell therapy in patients with acute myocardial infarction (AMI). The results of these studies have indicated that stem cell therapy is feasible and safe, and improves left ventricular (LV) systolic function and myocardial perfusion. Most of these studies have been performed for short follow-up periods ranging from 3 to 24 months. Clinical effects of stem/progenitor cell therapy were maintained up to 6 –12 months in most short-term follow-up studies, when most of the infused stem/progenitor cells did not remain in the recipients’ hearts. We believe that longterm evaluation of the clinical influence of stem/progenitor cell infusion helps us to understand and improve stem/progenitor cell therapy

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