Effect of intracoronary delivery of autologous bone marrow mononuclear cells 2 to 3 weeks following acute myocardial infarction on left ventricular function: the LateTIME randomized trial
Jay H Traverse, Timothy D Henry, Stephen G Ellis, Carl J Pepine, James T Willerson, David X M Zhao, John R Forder, Barry J Byrne, Antonis K Hatzopoulos, Marc S Penn, Emerson C Perin, Kenneth W Baran, Jeffrey Chambers, Charles Lambert, Ganesh Raveendran, Daniel I Simon, Douglas E Vaughan, Lara M Simpson, Adrian P Gee, Doris A Taylor, Christopher R Cogle, James D Thomas, Guilherme V Silva, Beth C Jorgenson, Rachel E Olson, Sherry Bowman, Judy Francescon, Carrie Geither, Eileen Handberg, Deirdre X Smith, Sarah Baraniuk, Linda B Piller, Catalin Loghin, David Aguilar, Sara Richman, Claudia Zierold, Judy Bettencourt, Shelly L Sayre, Rachel W Vojvodic, Sonia I Skarlatos, David J Gordon, Ray F Ebert, Minjung Kwak, Lemuel A Moyé, Robert D Simari, Cardiovascular Cell Therapy ResearchNetwork, Robert Simari, Timothy Henry, Jay Traverse, David McKenna, Beth Jorgenson, Rachel Olson, Stephen Ellis, Marc Penn, Saif Anwaruddin, James Harvey, Carrie Geither, Mark Jarosz, Cindy Oblak, Jane Reese Koc, James Willerson, Emerson Perin, Guilherme Silva, James Chen, Casey Kappenman, Deirdre Smith, Lynette Westbrook, Carl Pepine, Barry Byrne, Chris Cogle, John Wingard, Eileen Handberg, Tempa Curry, Diann Fisk, David Zhao, Antonis Hatzopoulos, Allen Naftilan, Sherry Bowman, Judy Francescon, Karen Prater, Paul Heart Clinic, Ken Baran, Jody LaRock, Jeffrey Chambers, Klaudija Dragicevic, Ganesh Raveendran, Barb Bruhn-Ding, Emily Caldwell, Daniel Simon, Marco Costa, Stacey Mazzurco, Charles Lambert, Elizabeth Szymanski, Biswajit Kar, Lemuel Moye, Lara Simpson, Linda Piller, Sarah Baraniuk, Dejian Lai, Shreela Sharma, Judy Bettencourt, Shelly Sayre, Rachel Vojvodic, Larry Cormier, Robert Brown, Diane Eady, Crystal Maitland, Courtney Ransom, Maybelle Sison, Michelle Cohen, Adrian Gee, Sara Richman, David Aguilar, Catalin Loghin, John Forder, Christopher R Cogle, Elizabeth Wise, James Thomas, Allen Borowski, Annitta Flinn, Cathy McDowell, Doris Taylor, Claudia Zierold, Marjorie Carlson, Jay H Traverse, Timothy D Henry, Stephen G Ellis, Carl J Pepine, James T Willerson, David X M Zhao, John R Forder, Barry J Byrne, Antonis K Hatzopoulos, Marc S Penn, Emerson C Perin, Kenneth W Baran, Jeffrey Chambers, Charles Lambert, Ganesh Raveendran, Daniel I Simon, Douglas E Vaughan, Lara M Simpson, Adrian P Gee, Doris A Taylor, Christopher R Cogle, James D Thomas, Guilherme V Silva, Beth C Jorgenson, Rachel E Olson, Sherry Bowman, Judy Francescon, Carrie Geither, Eileen Handberg, Deirdre X Smith, Sarah Baraniuk, Linda B Piller, Catalin Loghin, David Aguilar, Sara Richman, Claudia Zierold, Judy Bettencourt, Shelly L Sayre, Rachel W Vojvodic, Sonia I Skarlatos, David J Gordon, Ray F Ebert, Minjung Kwak, Lemuel A Moyé, Robert D Simari, Cardiovascular Cell Therapy ResearchNetwork, Robert Simari, Timothy Henry, Jay Traverse, David McKenna, Beth Jorgenson, Rachel Olson, Stephen Ellis, Marc Penn, Saif Anwaruddin, James Harvey, Carrie Geither, Mark Jarosz, Cindy Oblak, Jane Reese Koc, James Willerson, Emerson Perin, Guilherme Silva, James Chen, Casey Kappenman, Deirdre Smith, Lynette Westbrook, Carl Pepine, Barry Byrne, Chris Cogle, John Wingard, Eileen Handberg, Tempa Curry, Diann Fisk, David Zhao, Antonis Hatzopoulos, Allen Naftilan, Sherry Bowman, Judy Francescon, Karen Prater, Paul Heart Clinic, Ken Baran, Jody LaRock, Jeffrey Chambers, Klaudija Dragicevic, Ganesh Raveendran, Barb Bruhn-Ding, Emily Caldwell, Daniel Simon, Marco Costa, Stacey Mazzurco, Charles Lambert, Elizabeth Szymanski, Biswajit Kar, Lemuel Moye, Lara Simpson, Linda Piller, Sarah Baraniuk, Dejian Lai, Shreela Sharma, Judy Bettencourt, Shelly Sayre, Rachel Vojvodic, Larry Cormier, Robert Brown, Diane Eady, Crystal Maitland, Courtney Ransom, Maybelle Sison, Michelle Cohen, Adrian Gee, Sara Richman, David Aguilar, Catalin Loghin, John Forder, Christopher R Cogle, Elizabeth Wise, James Thomas, Allen Borowski, Annitta Flinn, Cathy McDowell, Doris Taylor, Claudia Zierold, Marjorie Carlson
Abstract
Context: Clinical trial results suggest that intracoronary delivery of autologous bone marrow mononuclear cells (BMCs) may improve left ventricular (LV) function when administered within the first week following myocardial infarction (MI). However, because a substantial number of patients may not present for early cell delivery, the efficacy of autologous BMC delivery 2 to 3 weeks post-MI warrants investigation.
Objective: To determine if intracoronary delivery of autologous BMCs improves global and regional LV function when delivered 2 to 3 weeks following first MI.
Design, setting, and patients: A randomized, double-blind, placebo-controlled trial (LateTIME) of the National Heart, Lung, and Blood Institute-sponsored Cardiovascular Cell Therapy Research Network of 87 patients with significant LV dysfunction (LV ejection fraction [LVEF] ≤45%) following successful primary percutaneous coronary intervention (PCI) between July 8, 2008, and February 28, 2011.
Interventions: Intracoronary infusion of 150 × 10(6) autologous BMCs (total nucleated cells) or placebo (BMC:placebo, 2:1) was performed within 12 hours of bone marrow aspiration after local automated cell processing.
Main outcome measures: Changes in global (LVEF) and regional (wall motion) LV function in the infarct and border zone between baseline and 6 months, measured by cardiac magnetic resonance imaging. Secondary end points included changes in LV volumes and infarct size.
Results: A total of 87 patients were randomized (mean [SD] age, 57 [11] years; 83% men). Harvesting, processing, and intracoronary delivery of BMCs in this setting was feasible. Change between baseline and 6 months in the BMC group vs placebo for mean LVEF (48.7% to 49.2% vs 45.3% to 48.8%; between-group mean difference, -3.00; 95% CI, -7.05 to 0.95), wall motion in the infarct zone (6.2 to 6.5 mm vs 4.9 to 5.9 mm; between-group mean difference, -0.70; 95% CI, -2.78 to 1.34), and wall motion in the border zone (16.0 to 16.6 mm vs 16.1 to 19.3 mm; between-group mean difference, -2.60; 95% CI, -6.03 to 0.77) were not statistically significant. No significant change in LV volumes and infarct volumes was observed; both groups decreased by a similar amount at 6 months vs baseline.
Conclusion: Among patients with MI and LV dysfunction following reperfusion with PCI, intracoronary infusion of autologous BMCs vs intracoronary placebo infusion, 2 to 3 weeks after PCI, did not improve global or regional function at 6 months.
Trial registration: clinicaltrials.gov Identifier: NCT00684060.
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Source: PubMed