Lamirault Guillaume, de Bock Elodie, Sébille Véronique, Delasalle Béatrice, Roncalli Jérôme, Susen Sophie, Piot Christophe, Trochu Jean-Noël, Teiger Emmanuel, Neuder Yannick, Le Tourneau Thierry, Manrique Alain, Hardouin Jean-Benoît, Lemarchand Patricia
INSERM, UMR1087, CNRS, UMR 6291, l'institut du thorax, Clinique cardiologique, CIC-thorax, Université de Nantes, CHU de Nantes, Nantes, 44000, France.
EA4275 SPHERE "bioStatistics, Pharmacoepidemiology and Human sciEnces REsearch", Université de Nantes, Nantes, France.
Qual Life Res. 2017 Jan;26(1):121-125. doi: 10.1007/s11136-016-1366-7. Epub 2016 Jul 20.
Cardiac cell therapy is a promising treatment for acute myocardial infarction (AMI), leading to cardiac function improvement. However, whether it translates into quality of life (QoL) improvement is unclear. We hypothesized that administration of bone marrow cells (BMC) to patients with AMI improves QoL.
In the multicenter BONAMI trial (NCT00200707), patients with reperfused AMI and decreased myocardial viability were randomized to intracoronary autologous BMC infusion (n = 52) or state-of-the-art therapy (n = 49). QoL data, derived from the Minnesota Living with Heart Failure questionnaire (MLHFQ), were obtained 1, 3, and 12 months after AMI and analyzed using a Rasch-family model.
Using this model, QoL improved over time in the BMC group (p = 0.025) but not in the control group. Furthermore, the BMC-group patients displayed a better QoL than the control-group patients at 3 and 12 months post-AMI (p = 0.034 and p = 0.003, respectively). These findings were not detected when analyzing MLHFQ data using a standard method. Cardiac function, myocardial viability, mortality, and number of major adverse cardiac events did not differ between treatment groups.
Our results suggest that BMC therapy can improve QoL, stressing the need for confirmation trials and for systematic QoL assessment in cardiac cell therapy trials .
心脏细胞治疗是急性心肌梗死(AMI)一种很有前景的治疗方法,可改善心脏功能。然而,其是否能转化为生活质量(QoL)的改善尚不清楚。我们假设对AMI患者给予骨髓细胞(BMC)可改善生活质量。
在多中心BONAMI试验(NCT00200707)中,将再灌注AMI且心肌活力下降的患者随机分为冠状动脉内自体BMC输注组(n = 52)或接受最佳治疗组(n = 49)。从明尼苏达心力衰竭生活问卷(MLHFQ)获得生活质量数据,在AMI后1、3和12个月获取,并使用Rasch族模型进行分析。
使用该模型,BMC组的生活质量随时间改善(p = 0.025),而对照组则未改善。此外,AMI后3个月和12个月时,BMC组患者的生活质量优于对照组患者(分别为p = 0.034和p = 0.003)。使用标准方法分析MLHFQ数据时未发现这些结果。治疗组之间的心脏功能、心肌活力、死亡率和主要不良心脏事件数量无差异。
我们的结果表明,BMC治疗可改善生活质量,强调需要进行确证试验以及在心脏细胞治疗试验中进行系统的生活质量评估。