• J Alberto San Roman, Pedro L Sánchez, Adolfo Villa, Ricardo Sanz-Ruiz, María Eugenia Fernandez-Santos, Federico Gimeno, Benigno Ramos, Roman Arnold, Ana Serrador, Hipólito Gutiérrez, Francisco Martin-Herrero, María Jesús Rollán, Felipe Fernández-Vázquez, Juan López-Messa, Pablo Ancillo, German Pérez-Ojeda, and Francisco Fernández-Avilés.
• Department of Cardiology, Instituto de Ciencias del Corazón, Valladolid, Spain.
• J. Am. Coll. Cardiol. 2015 Jun 9; 65 (22): 2372-82.

BackgroundStem cell-based therapy has emerged as a potential therapy in acute myocardial infarction (AMI). Although various approaches have been studied, intracoronary injection of bone marrow autologous mononuclear cells (BMMC) and the ability of granulocyte colony-stimulating factor (G-CSF) to mobilize endogenous cells have attracted the most attention.ObjectivesThis study compares, for the first time, the efficacy of BMMC injection, G-CSF mobilization, and the combination of both with standard treatment.MethodsOn Day 1 after primary percutaneous coronary intervention, 120 patients were randomized to a 1) intracoronary BMMC injection; 2) mobilization with G-CSF; 3) both (BMMC injection plus G-CSF); or 4) conventional treatment (control group). G-CSF, 10 μg/kg/day subcutaneously, was started Day 1 and maintained for 5 days. BMMC injection was performed on Days 3 to 5. Our primary endpoint was absolute change in 12-month left ventricular ejection fraction (LVEF) and left ventricular end-systolic volume (LVESV) relative to baseline measured by cardiac magnetic resonance.ResultsThe mean change in LVEF between baseline and follow-up for all patients was 4 ± 6% (p = 0.006). Change in LVEF and LVESV over time did not differ significantly among the 4 groups. Patients actively treated with any stem cell approach showed similar changes in LVEF and LVESV versus control subjects, with a small but significant reduction in infarct area (p = 0.038).ConclusionsIn our study, 3 different bone marrow-derived stem cell approaches in AMI did not result in improvement of LVEF or volumes compared with standard AMI care (Trial of Hematopoietic Stem Cells in Acute Myocardial Infarction [TECAM]; NCT00984178).Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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