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Stem-cell therapy in ST-segment elevation myocardial infarction with reduced ejection fraction: A multicenter, double-blind randomized trial.
Nicolau, José C; Furtado, Remo H M; Silva, Suzana A; Rochitte, Carlos E; Rassi, Anis; Moraes, João B M C; Quintella, Edgard; Costantini, Costantino R; Korman, Adrian P M; Mattos, Marco A; Castello, Hélio J; Caixeta, Adriano; Dohmann, Hans F R; de Carvalho, Antonio C C.
Afiliación
  • Nicolau JC; Coronary Care Unit, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.
  • Furtado RHM; Coronary Care Unit, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.
  • Silva SA; Clinical Research Unit, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
  • Rochitte CE; Cardiovascular Imaging Department, Instituto do Coração, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil.
  • Rassi A; Division of Cardiology, Anis Rassi Hospital, Goiânia, Brazil.
  • Moraes JBMC; Cardiology Department, Hospital Agamenon Magalhaes, Recife, Brazil.
  • Quintella E; Cardiology Department, Instituto de Cardiologia Aloysio de Castro, Rio de Janeiro, Brazil.
  • Costantini CR; Department of Interventional Cardiology, Hospital Cardiológico Costantini, Curitiba, Brazil.
  • Korman APM; Cardiology Department, Sociedade Divina Providencia Hospital Santa Isabel, Blumenau, Brazil.
  • Mattos MA; Clinical Research Unit, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
  • Castello HJ; Cardiology Department, Hospital Bandeirantes, São Paulo, Brazil.
  • Caixeta A; Department of Interventional Cardiology, Instituto do Coração do Distrito Federal, Brasília, Brazil.
  • Dohmann HFR; Cardiology Department, PROCEP/Amil Assistência Médica Internacional, Rio de Janeiro, Brazil.
  • de Carvalho ACC; Clinical Research Unit, Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil.
Clin Cardiol ; 41(3): 392-399, 2018 Mar.
Article en En | MEDLINE | ID: mdl-29569254
BACKGROUND: Left ventricular ejection fraction (LVEF) is a major determinant of long-term prognosis after ST-segment elevation myocardial infarction (STEMI). STEMI patients with reduced LVEF have a poor prognosis, despite successful reperfusion and the use of renin-angiotensin-aldosterone inhibitors. HYPOTHESIS: Intracoronary infusion of bone marrow-derived mononuclear cells (BMMC) may improve LVEF in STEMI patients successfully reperfused. METHODS: The main inclusion criteria for this double-blind, randomized, multicenter study were patient age 30 to 80 years, LVEF ≤50%, successful angioplasty of infarct-related artery, and regional dysfunction in the infarct-related area analyzed before cell injection. Cardiac magnetic resonance imaging was used to assess LVEF, left ventricular volumes, and infarct size at 7 to 9 days and 6 months post-myocardial infarction. RESULTS: One hundred and twenty-one patients were included (66 patients in the BMMC group and 55 patients in the placebo group). The primary endpoint, mean LVEF, was similar between both groups at baseline (44.63% ± 10.74% vs 42.23% ± 10.33%; P = 0.21) and at 6 months (44.74% ± 12.95 % vs 43.50 ± 12.43%; P = 0.59). The groups were also similar regarding the difference between baseline and 6 months (0.11% ± 8.5% vs 1.27% ± 8.93%; P = 0.46). Other parameters of left ventricular remodeling, such as systolic and diastolic volumes, as well as infarct size, were also similar between groups. CONCLUSIONS: In this randomized, multicenter, double-blind trial, BMMC intracoronary infusion did not improve left ventricular remodeling or decrease infarct size.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Función Ventricular Izquierda / Remodelación Ventricular / Trasplante de Células Madre / Infarto del Miocardio con Elevación del ST / Ventrículos Cardíacos Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cardiol Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
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Imprimir
XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Función Ventricular Izquierda / Remodelación Ventricular / Trasplante de Células Madre / Infarto del Miocardio con Elevación del ST / Ventrículos Cardíacos Tipo de estudio: Diagnostic_studies / Observational_studies / Prognostic_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cardiol Año: 2018 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos