PMID- 20095521
OWN - NLM
STAT- MEDLINE
DCOM- 20100309
LR  - 20190917
IS  - 0042-8450 (Print)
IS  - 0042-8450 (Linking)
VI  - 66
IP  - 12
DP  - 2009 Dec
TI  - Influence of intracoronary injections of bone-marrow-derived mononuclear cells on 
      large myocardial infarction outcome: quantum of initial necrosis is the key.
PG  - 998-1004
AB  - BACKGROUND/AIM: Autologous bone-marrow-derived intra= coronary injection of 
      mononuclear cells (MNC) modestly improved left ventricular ejection fraction 
      (LVEF) in the selected patients after acute ST elevation myocardial infarction 
      (STEMI). Major determinants of stem cell therapy outcome in the subacute phase of 
      STEMI still remain unknown. Therefore, the aim of this study was to determine 
      modifying factors for the outcome of stem cell therapy after STEMI. METHODS: 
      Eighteen patients in the stem cell therapy group and 24 patients in the control 
      group with the successfully reperfused first large STEMI (LVEF < or = 40%) were 
      enrolled in the study. The stem cell group was submitted to autologous 
      bone-marrow-derived MNC injection between 7-12 days after MI. Left ventricular 
      ejection fraction and infarction size at baseline and after 4 months were 
      determined by echocardiography and scintigraphy examination. Age, pain onset to 
      reperfusion time, admission glycemia, maximum lactate dehydrogenase (LDH) 
      activity and C-reactive protein level, baseline LVEF and infarction size, and the 
      number of MNC injected were compared between patients with and without 
      significant improvement of LVEF and decrease of myocardial infarct size after 4 
      months. RESULTS: In the stem cell group, patients with the improvement of LVEF 
      for more than 5.1% had significantly lower levels of LDH than patients without 
      such improvement (1689 +/- 139 vs 2133 +/- 215 IU/L, p < 0.001) and lower 
      baseline infarction size on scintigraphy (26.7 +/- 5.2 vs 34.9 +/- 3.7%, p < 
      0.001). Such dependence was not found in the control group. CONCLUSION: In the 
      patients with first large STEMI intracoronary injection of autologous 
      bone-marrow-derived MNC leads to the significant decrease of myocardial 
      infarction size but not the significant improvement of LVEF after four months. 
      Higher serum LDH levels after STEMI and very large baseline infarction size are 
      predictors of failure of stem cell therapy in our group of STEMI patients.
FAU - Obradovic, Slobodan
AU  - Obradovic S
AD  - Military Medical Academy, Clinic of Emergency Medicine, Belgrade, Serbia. 
      sloba.d.obradovic@gmail.com
FAU - Balint, Bela
AU  - Balint B
FAU - Romanovic, Radoslav
AU  - Romanovic R
FAU - Trifunovic, Zoran
AU  - Trifunovic Z
FAU - Rusovic, Sinisa
AU  - Rusovic S
FAU - Baskot, Branislav
AU  - Baskot B
FAU - Dopudja, Marija
AU  - Dopudja M
FAU - Trifunovic, Gordana
AU  - Trifunovic G
FAU - Rafajlovski, Saso
AU  - Rafajlovski S
FAU - Jung, Robert
AU  - Jung R
FAU - Gligic, Branko
AU  - Gligic B
LA  - eng
PT  - Journal Article
PL  - Serbia
TA  - Vojnosanit Pregl
JT  - Vojnosanitetski pregled
JID - 21530700R
SB  - IM
MH  - Echocardiography
MH  - Female
MH  - Heart/diagnostic imaging
MH  - *Hematopoietic Stem Cell Transplantation
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/diagnostic imaging/physiopathology/*therapy
MH  - Myocardium/pathology
MH  - Radionuclide Imaging
MH  - Transplantation, Autologous
MH  - Ventricular Function, Left
EDAT- 2010/01/26 06:00
MHDA- 2010/03/10 06:00
CRDT- 2010/01/26 06:00
PHST- 2010/01/26 06:00 [entrez]
PHST- 2010/01/26 06:00 [pubmed]
PHST- 2010/03/10 06:00 [medline]
AID - 10.2298/vsp0912998o [doi]
PST - ppublish
SO  - Vojnosanit Pregl. 2009 Dec;66(12):998-1004. doi: 10.2298/vsp0912998o.