J 2020

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

MATHUR, A.; F. FERNANDEZ-AVILES; J. BARTUNEK; A. BELMANS; F. CREA et al.

Základní údaje

Originální název

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.; F. FERNANDEZ-AVILES; J. BARTUNEK; A. BELMANS; F. CREA; S. DOWLUT; M. GALINANES; M. C. GOOD; J. HARTIKAINEN; C. HAUSKELLER; S. JANSSENS; Petr KALA; J. KASTRUP; J. MARTIN; P. MENASCHE; R. SANZ-RUIZ; S. YLA-HERTTUALA a A. ZEIHER

Vydání

European heart journal, Oxford, Oxford University Press, 2020, 0195-668X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 29.983

Označené pro přenos do RIV

Ano

Kód RIV

RIV/00216224:14110/20:00117708

Organizační jednotka

Lékařská fakulta

EID Scopus

Klíčová slova anglicky

ST-elevation myocardial infarction; Cell- and tissue-based therapy; Bone marrow cells

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 12. 1. 2021 13:07, Mgr. Tereza Miškechová

Anotace

V originále

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] .