• Volker Schächinger, Sandra Erbs, Albrecht Elsässer, Werner Haberbosch, Rainer Hambrecht, Hans Hölschermann, Jiangtao Yu, Roberto Corti, Detlef G Mathey, Christian W Hamm, Tim Süselbeck, Birgit Assmus, Torsten Tonn, Stefanie Dimmeler, Andreas M Zeiher, and REPAIR-AMI Investigators.
• Department of Internal Medicine III, Johann Wolfgang Goethe University, Frankfurt, Germany.
• N. Engl. J. Med. 2006 Sep 21; 355 (12): 1210-21.

BackgroundPilot trials suggest that the intracoronary administration of autologous progenitor cells may improve left ventricular function after acute myocardial infarction.MethodsIn 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.ResultsAt 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).ConclusionsIntracoronary 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.2006 Massachusetts Medical Society

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