Improved clinical outcome after intracoronary administration of bone-marrow-derived progenitor cells in acute myocardial infarction: final 1-year results of the REPAIR-AMI trial. |
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Authors: | Volker Sch?chinger Sandra Erbs Albrecht Els?sser Werner Haberbosch Rainer Hambrecht Hans H?lschermann Jiangtao Yu Roberto Corti Detlef G Mathey Christian W Hamm Tim Süselbeck Nikos Werner Jürgen Haase J?rg Neuzner Alfried Germing Bernd Mark Birgit Assmus Torsten Tonn Stefanie Dimmeler Andreas M Zeiher |
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Institution: | J. W. Goethe Universit?t Frankfurt, Med. Klinik III, Abt. Kardiologie, Theodor-Stern-Kai 7, 60590 Frankfurt a. M., Germany. |
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Abstract: | AIMS: To investigate the clinical outcome after intracoronary administration of autologous progenitor cells in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: Using a double-blind, placebo-controlled multicentre trial design, we randomized 204 patients with successfully reperfused AMI to receive intracoronary infusion of bone-marrow-derived progenitor cells (BMCs) or placebo medium into the infarct artery 3-7 days after successful infarct reperfusion therapy. At 12 months, the pre-specified cumulative endpoint of death, myocardial infarction, or necessity for revascularization was significantly reduced in the BMC group compared with placebo (P=0.009). Likewise, the combined endpoint death, recurrence of myocardial infarction, and rehospitalization for heart failure was significantly (P=0.006) reduced in patients receiving intracoronary BMC administration. Intracoronary administration of BMC remained a significant predictor of a favourable clinical outcome by Cox regression analysis, adjusting for classical predictors of poor outcome after AMI. CONCLUSION: Intracoronary administration of BMCs is associated with a significant reduction of the occurrence of major adverse cardiovascular events after AMI. Large-scale studies are warranted to confirm the effects of BMC administration on mortality and morbidity in patients with AMIs. |
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