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Updated: Apr 11, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Timing for intracoronary administration of bone marrow mononuclear cells after acute ST-elevation myocardial
Rongchong Huang1,2, Kang Yao2, Aijun Sun2,3
1The First Affiliated Hospital of Dalian Medical University, 222 Zhongshan Road, Dalian, 116011, China.
Insights
Intracoronary bone marrow mononuclear cell therapy for acute myocardial infarction shows similar benefits when administered within 24 hours or 3-7 days after primary percutaneous coronary intervention (PCI). Early administration within 24 hours is more cost-effective and leads to shorter hospital stays than treatment 3-7 days post-PCI.
Area of Science:
- Cardiology
- Regenerative Medicine
- Interventional Cardiology
Background:
- Optimal timing for intracoronary bone marrow mononuclear cell (BM-MNC) transplantation in acute myocardial infarction (AMI) remains unclear.
- Most studies initiate treatment 3-7 days post-primary percutaneous coronary intervention (PCI).
- This study investigates therapeutic effects of BM-MNC transplantation at varying times after ST-elevation myocardial infarction (STEMI).
Purpose of the Study:
- To evaluate the therapeutic efficacy of intracoronary BM-MNC transplantation at different time points following primary PCI in STEMI patients.
- To compare the effects of early (within 24 hours) versus delayed (3-7 days or 7-30 days) cell therapy on cardiac function and remodeling.
Main Methods:
- A randomized trial involving 104 STEMI patients with left ventricular ejection fraction <50% who underwent primary PCI.
- Patients were assigned to receive intracoronary BM-MNC infusion within 24 hours (Group A), 3-7 days (Group B), or 7-30 days (Group C) post-PCI, or saline control.
- Echocardiography assessed left ventricular ejection fraction, end-systolic volume, and end-diastolic volume at 12 months.
Main Results:
- Groups A and B demonstrated significantly greater improvements in left ventricular ejection fraction and reductions in end-systolic volume compared to control and Group C at 12 months.
- Myocardial perfusion also showed significant improvement in Groups A and B versus control and Group C.
- No significant differences in cardiac function or geometry were observed between Group A and Group B; however, Group B incurred higher costs and longer hospital stays.
Conclusions:
- Intracoronary BM-MNC transplantation for STEMI is therapeutically effective when administered within 24 hours or 3-7 days after primary PCI.
- Early administration (within 24 hours) offers similar clinical benefits to treatment within 3-7 days but is more cost-effective with shorter hospitalizations.
Introduction:
Most studies on intracoronary bone marrow mononuclear cell transplantation for acute myocardial infarction involve treatment 3-7 days after primary percutaneous coronary intervention (PCI); however, the optimal timing is unknown. The present study assessed the therapeutic effect at different times after ST-elevation myocardial infarction.
Methods:
The present trial was not blinded. A total of 104 patients with a first ST-elevation myocardial infarction and a left ventricular ejection fraction below 50 %, who had PCI of the infarct-related artery, were randomly assigned to receive intracoronary infusion of bone marrow mononuclear cells within 24 hours (group A, n = 27), 3 to 7 days after PCI (group B, n = 26), or 7 to 30 days after PCI (group C, n = 26), or to the control group (n = 25), which received saline infusion performed immediately after emergency PCI. All patients in groups A, B and C received an injection of 15 ml cell suspension containing approximately 4.9 × 10(8) bone marrow mononuclear cells into the infarct-related artery after successful PCI.
Results:
Compared to control and group C patients, group A and B patients had a significantly higher absolute increase in left ventricular ejection fraction from baseline to 12 months (change: 3.4 ± 5.7 % in control, 7.9 ± 4.9 % in group A, 6.9 ± 3.9 % in group B, 4.7 ± 3.7 % in group C), a greater decrease in left ventricular end-systolic volumes (change: -6.4 ± 15.9 ml in control, -20.5 ± 13.3 ml in group A, -19.6 ± 11.1 ml in group B, -9.4 ± 16.3 ml in group C), and significantly greater myocardial perfusion (change from baseline: -4.7 ± 5.7 % in control, -7.8 ± 4.5 % in group A, -7.5 ± 2.9 % in group B, -5.0 ± 4.0 % in group C). Group A and B patients had similar beneficial effects on cardiac function (p = 0.163) and left ventricular geometry (left ventricular end-distolic volume: p = 0.685; left ventricular end-systolic volume: p = 0.622) assessed by echocardiography, whereas group C showed similar results to those of the control group. Group B showed more expensive care (p < 0.001) and longer hospital stays during the first month after emergency PCI (p < 0.001) than group A, with a similar improvement after repeat cardiac catheterization following emergency PCI.
Conclusion:
Cell therapy in acute myocardial infarction patients that is given within 24 hours is similar to 3-7 days after the primary PCI.
Trial Registration:
NCT02425358 , registered 30 April 2015.
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