The effect of intracoronary infusion of bone marrow-derived mononuclear cells on all-cause mortality in acute myocardial infarction: the BAMI trial

Autoři	MATHUR A. FERNANDEZ-AVILES F. BARTUNEK J. BELMANS A. CREA F. DOWLUT S. GALINANES M. GOOD M. C. HARTIKAINEN J. HAUSKELLER C. JANSSENS S. KALA Petr KASTRUP J. MARTIN J. MENASCHE P. SANZ-RUIZ R. YLA-HERTTUALA S. ZEIHER A.
Rok publikování	2020
Druh	Článek v odborném periodiku
Časopis / Zdroj	European heart journal
Fakulta / Pracoviště MU	Lékařská fakulta
Citace
www	https://watermark.silverchair.com/ehaa651.pdf?token=AQECAHi208BE49Ooan9kkhW_Ercy7Dm3ZL_9Cf3qfKAc485ysgAAAtowggLWBgkqhkiG9w0BBwagggLHMIICwwIBADCCArwGCSqGSIb3DQEHATAeBglghkgBZQMEAS4wEQQMDy2VyrZlWWSysS8wAgEQgIICjf12t8DWBHBExxXmCAdSqIQrDNtwQdhGB6FEhxpj6coL8l
Doi	http://dx.doi.org/10.1093/eurheartj/ehaa651
Klíčová slova	ST-elevation myocardial infarction; Cell- and tissue-based therapy; Bone marrow cells
Popis	Aims Bone marrow-derived mononuclear cell (BM-MNC) therapy may improve myocardial recovery in patients following acute myocardial infarction (AMI), though existing trial results are inconsistent. Methods and results Originally an open-label, multicentre Phase III trial, BAMI was designed to demonstrate the safety and efficacy of intracoronary infusion of BM-MNCs in reducing the time to all-cause mortality in patients with reduced left ventricular ejection fraction (LVEF, <45%) after primary angioplasty (PPCI) for ST-elevation AMI. Unexpectedly low recruitment means the trial no longer qualifies as a hypothesis-testing trial, but is instead an observational study with no definitive conclusions possible from statistical analysis. In total, 375 patients were recruited: 185 patients were randomized to the treatment arm (intracoronary infusion of BM-MNCs 2-8 days after PPCI) and 190 patients to the control arm (optimal medical therapy). All-cause mortality at 2 years was 3.26% [6 deaths; 95% confidence interval (CI): 1.48-7.12%] in the BM-MNC group and 3.82% (7 deaths; 95% CI: 1.84-7.84%) in the control group. Five patients (2.7%, 95% CI: 1.0-5.9%) in the BM-MNC group and 15 patients (8.1%, CI : 4.7-12.5%) in the control group were hospitalized for heart failure during 2 years of follow-up. Neither adverse events nor serious adverse events differed between the two groups. There were no patients hospitalized for stroke in the control group and 4 (2.2%) patients hospitalized for stroke in the BM-MNC group. Conclusions Although BAMI is the largest trial of autologous cell-based therapy in the treatment of AMI, unexpectedly low recruitment and event rates preclude any meaningful group comparisons and interpretation of the observed results. [GRAPHICS] .