BONE MARROW-DERIVED STEM CELL THERAPY IN HEART FAILURE PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

Abstract

Despite continuous advancements in treating acute myocardial infarction (AMI), the incidence of heart failure after AMI is still around 10-15%. Intracoronary infusion of bone marrow-derived stem/progenitor cells (BMC) has emerged as a novel approach toregenerate injured cardiac myocytes. The study objective is to evaluate the short- term effectiveness of BMC therapy in acute phase after AMI on global left ventricular (LV) function. The study was conducted  from January 2011 to June 2014, in Vietnam Heart Institute on 100 acute AMI patients who had primary percutaneous coronary intervention (PCI) and were screened by echocardiography during first 5 days after primary PCI. Patients with LV function (measured by the Simpson method on echocardiography or magnetic resonance imaging (MRI)) less than 50% were recruited to either the control group (n=50) or the BMC group (n=50). Patients were monitored for 12 months. The results showed that, after 12 months, the incidence of the prespecified combined clinical end point of death, recurrence of myocardial infarction, and coronary revascularization, rehospitalization for heart failure was significantly lower in the BMC group (12%) than in the control group (26%) - p=0.041. The improvement in NYHA classification and pro-BNP was statistically significant in both the groups (p<0.05). The absolute improvement in LVEF was significantly greater in the BMC group than in the control group (p<0.05). In conclusion, intracoronary infusion of bone marrow- derived stem cells is feasible and effective in treating patients with heart failure after acute myocardial infarction.