Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, 101 DaeHak-ro, JongRo-gu, Seoul 110-744, South Korea.
Eur Heart J. 2012 Dec;33(24):3062-9. doi: 10.1093/eurheartj/ehs231. Epub 2012 Aug 17.
To evaluate the long-term effects of peripheral blood stem cell therapy in myocardial infarction (MI) patients.
A total of 163 patients with MI who were successfully revascularized with drug-eluting stents were enrolled and randomly assigned to four groups: acute MI (AMI) cell infusion, AMI control, old MI (OMI) cell infusion, and OMI control. We compared 5 years' clinical outcomes between the cell infusion group (57 and 22 patients with AMI and OMI, respectively) and the control (60 and 24 patients with AMI and OMI, respectively). In the time-sequence comparison from baseline to 6 and 24 months follow-up after AMI, left ventricular ejection fraction (LVEF) by cardiac magnetic resonance imaging was significantly improved in the cell infusion group (n = 57), but not in the control group (n = 60). In the between-group comparison, the difference in improvement of LVEF for 2 years after AMI did not reach statistical significance between cell infusion and control groups. Intriguingly, the major adverse cardiac events for 5 years were significantly reduced in the cell infusion group (n = 79) compared with the control (n = 84; composite of cardiac death, non-fatal MI, hospitalization for heart failure and angina, and target vessel revascularization; 22.8 vs. 39.3%, P = 0.015).
Peripheral blood stem cell therapy has potential to improve long-term cardiovascular outcomes in MI patients.
评估外周血干细胞疗法对心肌梗死（MI）患者的长期疗效。
共纳入 163 例经药物洗脱支架成功再血管化的 MI 患者，并随机分为四组：急性 MI（AMI）细胞输注组、AMI 对照组、陈旧性 MI（OMI）细胞输注组和 OMI 对照组。我们比较了细胞输注组（AMI 和 OMI 分别为 57 例和 22 例）和对照组（AMI 和 OMI 分别为 60 例和 24 例）5 年的临床结局。在 AMI 后 6 个月和 24 个月的时间序列比较中，心脏磁共振成像显示左心室射血分数（LVEF）在细胞输注组（n = 57）明显改善，但在对照组（n = 60）中没有改善。在组间比较中，AMI 后 2 年 LVEF 的改善差异在细胞输注组和对照组之间没有达到统计学意义。有趣的是，细胞输注组（n = 79）与对照组（n = 84；复合终点为心脏死亡、非致命性 MI、心力衰竭和心绞痛住院及靶血管血运重建；22.8%比 39.3%，P = 0.015）5 年内主要不良心脏事件显著减少。
外周血干细胞疗法有可能改善 MI 患者的长期心血管结局。
