TY - JOUR
T1 - Long term outcome after mononuclear bone marrow or peripheral blood cells infusion after myocardial infarction
AU - Delewi, Ronak
AU - Van Der Laan, Anja M.
AU - Robbers, Lourens F H J
AU - Hirsch, Alexander
AU - Nijveldt, Robin
AU - Van Der Vleuten, Pieter A.
AU - Tijssen, Jan G P
AU - Tio, René A.
AU - Waltenberger, Johannes
AU - Ten Berg, Jurrien M.
AU - Doevendans, Pieter A.
AU - Gehlmann, Helmut R.
AU - Van Rossum, Albert C.
AU - Piek, Jan J.
AU - Zijlstra, Felix
PY - 2015/3/1
Y1 - 2015/3/1
N2 - 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 3-5 days, and 4 months after AMI, all patients underwent cardiac MRI after 2 years. A follow-up for 5 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 5 years after AMI. BMMC group showed less increase in LV enddiastolic volume (LVEDV) (3.5±16.9 mL/m2) compared with (11.2±19.8 mL/m2, p=0.03) in the control group, with no difference between the PBMC group (9.2 ±20.9 mL/m2) and controls (p=0.69). Moreover, the BMMC group showed a trend for decrease in LV end systolic volume (-1.8±15.0 mL/m2) as compared with controls (3.0±16.3 mL/m2, p=0.07), with again no difference between PBMC (3.3±18.8 mL/m2) 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.
AB - 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 3-5 days, and 4 months after AMI, all patients underwent cardiac MRI after 2 years. A follow-up for 5 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 5 years after AMI. BMMC group showed less increase in LV enddiastolic volume (LVEDV) (3.5±16.9 mL/m2) compared with (11.2±19.8 mL/m2, p=0.03) in the control group, with no difference between the PBMC group (9.2 ±20.9 mL/m2) and controls (p=0.69). Moreover, the BMMC group showed a trend for decrease in LV end systolic volume (-1.8±15.0 mL/m2) as compared with controls (3.0±16.3 mL/m2, p=0.07), with again no difference between PBMC (3.3±18.8 mL/m2) 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.
UR - http://www.scopus.com/inward/record.url?scp=84922875499&partnerID=8YFLogxK
U2 - 10.1136/heartjnl-2014-305892
DO - 10.1136/heartjnl-2014-305892
M3 - Article
C2 - 25294647
AN - SCOPUS:84922875499
SN - 1355-6037
VL - 101
SP - 363
EP - 368
JO - Heart
JF - Heart
IS - 5
ER -