Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction
Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction
复制标题
DOI：
10.1056/nejmoa060186
复制
发表时间：
2006-09-21
影响因子：
158.5
通讯作者：
Zeiher, Andreas M.
中科院分区：
文献类型：
--
作者：
Schaechinger, Volker;Erbs, Sandra;Zeiher, Andreas M.
方法：在一项多中心试验中，我们随机将204例急性心肌梗死患者随机分为两组，在再灌注治疗成功后3-7天，将来源于骨髓(BMC)或安慰剂的祖细胞注入梗死动脉。结果：在4个月时，BMC组的整体左心室射血分数(LVEF)的绝对改善显著大于安慰剂组(平均[+/-SD]增加5.5+/-7.3%vs.3.0+/-6.5%；P=0.01)。基线左心室射血分数在48.9%或以下的患者获益最多(左心室射血分数绝对改善，5.0%；95%可信区间，2.0至8.1)。在1年时，冠状动脉内注射BMC与预先指定的联合临床终点、心肌梗死复发和任何血管重建术的减少相关(P=0.01)。结论：冠状动脉内注射BMC与促进急性心肌梗死患者左室收缩功能的恢复有关。有必要进行大规模研究，以考察祖细胞给药对发病率和死亡率的潜在影响。
BACKGROUND:Pilot trials suggest that the intracoronary administration of autologous progenitor cells may improve left ventricular function after acute myocardial infarction.METHODS:In a multicenter trial, we randomly assigned 204 patients with acute myocardial infarction to receive an intracoronary infusion of progenitor cells derived from bone marrow (BMC) or placebo medium into the infarct artery 3 to 7 days after successful reperfusion therapy.RESULTS:At 4 months, the absolute improvement in the global left ventricular ejection fraction (LVEF) was significantly greater in the BMC group than in the placebo group (mean [+/-SD] increase, 5.5+/-7.3% vs. 3.0+/-6.5%; P=0.01). Patients with a baseline LVEF at or below the median value of 48.9% derived the most benefit (absolute improvement in LVEF, 5.0%; 95% confidence interval, 2.0 to 8.1). At 1 year, intracoronary infusion of BMC was associated with a reduction in the prespecified combined clinical end point of death, recurrence of myocardial infarction, and any revascularization procedure (P=0.01).CONCLUSIONS:Intracoronary administration of BMC is associated with improved recovery of left ventricular contractile function in patients with acute myocardial infarction. Large-scale studies are warranted to examine the potential effects of progenitor-cell administration on morbidity and mortality.