Long term outcome after mononuclear bone marrow or peripheral blood cells infusion after myocardial infarction.
Heart
; 101(5): 363-8, 2015 Mar.
Article
em En
| MEDLINE
| ID: mdl-25294647
ABSTRACT
OBJECTIVES:
This study reports the long-term follow-up of the randomised controlled HEBE trial. The HEBE study is a multicentre trial that randomised 200 patients with large first acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention to either intracoronary infusion of bone marrow mononuclear cells (BMMCs) (n=69), peripheral blood mononuclear cells (PBMCs) (n=66) or standard therapy (n=65).METHODS:
In addition to 3-5â days, and 4â months after AMI, all patients underwent cardiac MRI after 2â years. A follow-up for 5â years after AMI was performed to assess clinical adverse events, including death, myocardial reinfarction and hospitalisation for heart failure.RESULTS:
Of the 200 patients enrolled, 9 patients died and 12 patients were lost to follow-up at 5â years after AMI. BMMC group showed less increase in LV end-diastolic volume (LVEDV) (3.5±16.9â mL/m(2)) compared with (11.2±19.8â mL/m(2), p=0.03) in the control group, with no difference between the PBMC group (9.2±20.9â mL/m(2)) and controls (p=0.69). Moreover, the BMMC group showed a trend for decrease in LV end systolic volume (-1.8±15.0â mL/m(2)) as compared with controls (3.0±16.3â mL/m(2), p=0.07), with again no difference between PBMC (3.3±18.8â mL/m(2)) and controls (p=0.66). The combined endpoint of death and hospitalisation for heart failure was non-significantly less frequent in the BMMC group compared with the control group (n=4 vs n=1, p=0.20), with no difference between PBMC and controls (n=6 vs n=4, p=0.74). The composite endpoint of death or recurrent myocardial infarction was significantly higher in the PBMC group compared with controls (14 patients vs 3 patients, p=0.008), with no difference between the BMMC group and controls (2 vs 3 patients, p=0.67).CONCLUSIONS:
Long-term follow-up of the HEBE trial showed that increase in LVEDV was lower in the BMMC group. This study supports the long-term safety of intracoronary BMMC therapy. However, major clinical cardiovascular adverse events were significantly more frequent in the PBMC group. TRIAL REGISTRATION NUMBER The Netherlands Trial Register #NTR166 (http//www.trialregister.nl) and the International Standard Randomised Controlled Trial, #ISRCTN95796863 (http//isrctn.org).
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
/
Transplante_de_medula_ossea
Base de dados:
MEDLINE
Assunto principal:
Leucócitos Mononucleares
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Transplante de Medula Óssea
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Infarto do Miocárdio
Tipo de estudo:
Clinical_trials
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Heart
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Holanda