Stem-cell therapy in ST-segment elevation myocardial infarction with reduced ejection fraction: A multicenter,...

Area of Science:

• Cardiology
• Regenerative Medicine
• Interventional Cardiology

Background:

• Left ventricular ejection fraction (LVEF) is crucial for prognosis in ST-segment elevation myocardial infarction (STEMI) patients.
• Reduced LVEF post-STEMI indicates a poor long-term outlook, even with optimal medical therapy.
• Investigating novel cell-based therapies is essential for improving outcomes in STEMI survivors with impaired cardiac function.

Purpose of the Study:

• To evaluate the efficacy of intracoronary bone marrow-derived mononuclear cells (BMMC) infusion in improving LVEF in STEMI patients.
• To assess the impact of BMMC on left ventricular remodeling and infarct size.
• To determine if BMMC therapy offers a benefit beyond standard reperfusion strategies.

Main Methods:

• A double-blind, randomized, multicenter clinical trial involving 121 STEMI patients with LVEF ≤50% and successful angioplasty.
• Patients received either intracoronary BMMC or a placebo.
• Cardiac magnetic resonance imaging (CMR) was used to measure LVEF, left ventricular volumes, and infarct size at baseline, 7-9 days, and 6 months post-myocardial infarction.

Main Results:

• No significant difference in mean LVEF was observed between the BMMC group and the placebo group at 6 months (44.74% vs 43.50%, P=0.59).
• Changes in LVEF from baseline to 6 months were also similar between the groups (0.11% vs 1.27%, P=0.46).
• Left ventricular volumes and infarct size remained comparable between the BMMC and placebo groups at all assessment points.

Conclusions:

• Intracoronary infusion of BMMC did not lead to significant improvements in LVEF in STEMI patients.
• BMMC therapy did not demonstrate a benefit in reducing left ventricular remodeling or infarct size.
• The study concludes that BMMC infusion is not effective for improving cardiac function or structure post-STEMI in this patient cohort.