Effects of intracoronary injection of mononuclear bone marrow cells on left ventricular function, arrhythmia risk profile, and restenosis after thrombolytic therapy of acute myocardial infarction
Effects of intracoronary injection of mononuclear bone marrow cells on left ventricular function, arrhythmia risk profile, and restenosis after thrombolytic therapy of acute myocardial infarction
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DOI：
10.1093/eurheartj/ehn436
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发表时间：
2008-11-01
影响因子：
39.3
通讯作者：
Makikallio, Timo H.
中科院分区：
文献类型：
--
作者：
Huikuri, Heikki V.;Kervinen, Kari;Makikallio, Timo H.
为评价急性ST段抬高型心肌梗死(STEMI)溶栓治疗后骨髓细胞(BMC)治疗的有效性和安全性，将STEMI患者随机分为两组，每组40例，分别于溶栓治疗后2~6d行冠状动脉内注射BMC(n=40)和安慰剂对照组(n=40)，于介入治疗前3~6h收集并制备骨髓细胞，支架植入后即刻注入梗死区。通过左心室造影和二维超声心动图测量左心室射血分数(LVEF)来评价疗效，通过血管内超声测量心律失常危险因素和支架内血管再狭窄来评价安全性。6个月后，无论是通过血管造影(平均+/-SD增加7.1+/-12.3vs.1.2+/-11.5%，P=0.05)还是通过二维超声心动图(平均+/-SD增加4.0+/-11.2vs.-1.4+/-10.2%，P=0.03)，BMC组的整体LVEF绝对值增加均大于安慰剂组。两组在不良临床事件、心律失常风险变量和支架冠状动脉病变的最小管腔直径方面没有差异。冠状动脉内BMC治疗与改善整体左心室射血分数和中性效应有关，对STEMI溶栓治疗后的心律失常风险分布和支架冠状动脉病变的再狭窄具有中性作用。
To assess the efficacy and safety of bone marrow cell (BMC) therapy after thrombolytic therapy of an acute ST-elevation myocardial infarction (STEMI).Patients with STEMI treated with thrombolysis followed by percutaneous coronary intervention (PCI) 2-6 days after STEMI were randomly assigned to receive intracoronary BMCs (n = 40) or placebo medium (n = 40), collected and prepared 3-6 h prior PCI and injected into the infarct artery immediately after stenting. Efficacy was assessed by the measurement of global left ventricular ejection fraction (LVEF) by left ventricular angiography and 2-D echocardiography, and safety by measuring arrhythmia risk variables and restenosis of the stented vessel by intravascular ultrasound. At 6 months, BMC group had a greater absolute increase of global LVEF than placebo group, measured either by angiography (mean +/- SD increase 7.1 +/- 12.3 vs. 1.2 +/- 11.5%, P = 0.05) or by 2-D echocardiography (mean +/- SD increase 4.0 +/- 11.2 vs. -1.4 +/- 10.2%, P = 0.03). No differences were observed between the groups in the adverse clinical events, arrhythmia risk variables, or the minimal lumen diameter of the stented coronary lesion.Intracoronary BMC therapy is associated with an improvement of global LVEF and neutral effects on arrhythmia risk profile and restenosis of the stented coronary lesions in patients after thrombolytic therapy of STEMI.