Intra-coronary Bone Marrow Mononuclear Cell Transplantation in Patients with ST-Elevation Myocardial Infarction: A Randomized Controlled Study
Suphot Srimahachota MD*, Smonporn Boonyaratavej MD*, Pairoj Rerkpattanapipat MD**, Somjai Wangsupachart MD**, Monravee Tumkosit MD**, Udomsak Bunworasate MD***, Thayapong Na Nakorn MD***, Tanin Intragumtornchai MD***, Pawinee Kupatawintu RN*****, Sunisa Pongam RN*, Aem-orn Saengsiri RN*, Mantana Pothisri RN**, Yeesoon Sukseri RN*, Tanorm Bunprasert MD****, Taworn Suithichaiyakul MD*
Affiliation : * Division of Cardiology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand ** Department of Radiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand *** Division of Hematology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand **** Department of Ear Nose Throat, King Chulalongkorn Memorial Hospital, Bangkok, Thailand ***** Blood Bank, Thai Red Cross Society, Bangkok, Thailand
Background : Stem cell transplantation is a potential treatment to improve left ventricular ejection fraction (LVEF) after ST
elevation myocardial infarction (STEMI). However, the outcomes still are controversial.
Objective : To determine the 6-month LVEF of the patients who underwent intra-coronary bone marrow mononuclear cell
(BMC) transplantation in patients with STEMI compared with controlled subjects.
Material and Method: After successful percutaneous coronary intervention (PCI) in STEMI patients who had LVEF was less
than 50% were randomized to intra-coronary BMC transplantation or control. Bone marrow aspiration of 100 cc was
performed in the morning. After cell processing for three hours, the suspension of BMC about 10 cc were infused to infracted
area using standard PCI technique. Balloon occlusion for three minutes was performed during cell infusion. Cardiac
magnetic resonance imaging was used to determine LVEF, scar volume and LV volume before and six-month follow-up.
Results : Between September 2006 and July 2008, 23 patients (11 in BMC group and 12 in control group) were enrolled. Mean
BMC count before transplant was 420 x 106 cell with 96% viability. At six-month follow-up, New York Heart Association
function class significantly improved in both groups (2.3 + 0.6 to 1.2 + 0.4 for BMC and 2.3 + 0.7 to 1.3 + 0.5 for control
group) but no difference was seen between groups. However, scar volume, wall motion score index, and LVEF did not show
improvement after six months in both groups (33.7 + 7.7 to 33.5 + 7.6 for BMC and 31.1 + 7.1 to 32.6 + 8.3 for control
group). No complication was observed during the procedure.
Conclusion : BMC transplantation intra-coronary in patients with STEMI in KCMH was feasible and safe but LVEF
improvement could not be demonstrated.
Keywords : Intracoronary, Bone marrow mononuclear cell transplantation, ST elevation myocardial infarction
