Long term outcome after mononuclear bone marrow or peripheral blood cells infusion after myocardial infarction. Issue 5 (7th October 2014)

• Record Type: Journal Article
• Authors: Delewi, Ronak; van der Laan, Anja M; Robbers, Lourens F H J; Hirsch, Alexander; Nijveldt, Robin; van der Vleuten, Pieter A; Tijssen, Jan G P; Tio, René A; Waltenberger, Johannes; ten Berg, Jurrien M; Doevendans, Pieter A; Gehlmann, Helmut R; van Rossum, Albert C; Piek, Jan J; Zijlstra, Felix
• Is Part Of: Heart. Volume 101:Issue 5(2015)
• Page Start: 363
• Page End: 368
• Publication Date: 2014-10-07
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2014-305892
• Languages: English
• ISSNs: 1355-6037

Abstract

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 3–5 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 end-diastolic volume (LVEDV) (3.5±16.9 mL/m 2 ) compared with (11.2±19.8 mL/m 2, p=0.03) in the control group, with no difference between the PBMC group (9.2±20.9 mL/m 2 ) and controls (p=0.69). Moreover, the BMMC group showed a trend for decrease in LV end systolic volume (−1.8±15.0 mL/m 2 ) as compared with controls (3.0±16.3 mL/m 2, p=0.07), with again no difference between PBMC (3.3±18.8 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 ).