The influence of intracoronary injection of bone marrow cells on prothrombotic markers in patients with acute myocardial infarction.

INTRODUCTION

The effects of intracoronary injection of mononuclear bone marrow cells (mBMC) on haemostasis are not clarified. The aim of the present substudy of the autologous stem cell transplantation in acute myocardial infarction (ASTAMI) trial was to investigate the influence of intracoronary injection of mBMC on selected circulating prothrombotic markers.

MATERIALS AND METHODS

One hundred patients with ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) on the left descending coronary artery were randomized to receive mBMC (Tx) (median 6 days after the STEMI) or to a control group. Fasting blood samples were drawn the day before Tx (day-1, 4-5 days after the STEMI), and 1 day, 3 days, 2-3 weeks and 3 months after Tx.

RESULTS

No significant differences in changes between the groups were observed from day-1 to any later time points in the levels of TF (tissue factor), F1+2 (prothrombin fragment 1+2), D-dimer, ETP (endogenous thrombin potential), PAI-1 (plasminogen activator inhibitor 1) or tissue plasminogen activator. However, TF and F1+2 decreased from day-1 to the subsequent time points in both groups, except from a small increase of TF at 3 months in the control group. In both groups, D-dimer and ETP decreased from day-1 to 2-3 weeks and 3 months, whereas PAI-1 increased to 2-3 weeks and 3 months.

CONCLUSIONS

Intracoronary injection of mBMC did not influence on prothrombotic markers in patients with STEMI. Reduction in several prothrombotic markers from day-1 to 2-3 weeks and 3 months could be demonstrated in both groups indicating decreased hypercoagulability. This is a substudy of the ASTAMI trial which is registered at www.clinicaltrials.gov, NCT 00199823.