Long-term clinical efficacy of transplantation of autologous bone marrow mononuclear cell transplantation in acute myocardial infarction with ST-segment elevation
AbstractAim: to examine the long-term clinical results of autologous bone marrow mononuclear cells in patients with acute myocardial infarction (AMI) with ST-segment elevation and the factors influencing the effectiveness of stem cell therapy.
Material and methods. The total of 62 patients with primary AMI were included in the open randomized study. All patients were randomized to two groups: group 1 (main group) included patients who received infarct-related coronary artery stenting and cellular cardiomyoplasty at 20+10 days after onset of AMI (n=28); group 2 (control group) included patients with infarct-related coronary artery (n=34). Follow-up study was performed 7,96+0,96 years after AMI and consisted in the evaluation of clinical course of coronary artery disease, physical examination, exercise tolerance assessment by 6-min walking test, echocardiography and serum BNP test. Result. Chronic heart failure of functional class II and higher was found more often in group 2: [12 (35%) vs. 4 (14%), р=0,05]. Control group had higher frequency of hospitalizations due to cardiovascular disease including unstable angina (12 (35%) vs. 5 (18), p=0,05). However, cardiovascular mortality was higher in group 1 than group 2 [36% (n=10) vs. 12% (n=4), p=0,02].
Conclusion. Cellular cardiomyoplasty of autologous mononuclear bone marrow cells is a safe procedure, but it has no positive impact on the long-term survival of patients. The relatively low ability to hold ABMMC in MI area, late timing of transplantation of AMI onset (after the 20th day) are the likely causes of lack of effectiveness of transplantation ABMMC.
Keywords:transplantation of autologous mononuclear autologous bone marrow mononuclear cells, acute myocardial infarction
DOI: 10.24411/2309-1908-2017-00013