J. Cell. Mol. Med. Vol 10, No 3, 2006 pp. 727-733
Acute myocardial infarction (AMI) is a major cause of
cardiovascular mortality worldwide. Impaired myocar-
dial contractility during AMI serves as a main predictor
for ventricular dysfunction with subsequent develop-
ment of chronic heart failure. Therefore, the timely and
accurate re-canalization of acute coronary occlusion is
of particular importance for improving survival, but
also quality of life. Beyond the well documented and
widely acknowledged advances in coronary revascular-
ization including application of drug-eluting stents and
Intracoronary infusion of autologous bone marrow cells and
left ventricular function after acute myocardial infarction:
M. Hristova, Nicole Heussenb, A. Schoberc, C. Webera *
a Institute for Molecular Cardiovascular Research (IMCAR) and Interdisciplinary
Center for Clinical Research "BIOMAT", RWTH University Hospital Aachen, Aachen, Germany
b Institute for Medical Statistics, RWTH University Hospital Aachen, Aachen, Germany
c Department of Cardiology, Ludwig-Maximilians-University München, Germany
Received: May 4, 2006; Accepted: June 30, 2006
Recent clinical studies have demonstrated that intracoronary infusion of autologous bone marrow cells (BMC) in con-
junction with standard treatment may improve left ventricular function after an acute myocardial infarction (AMI).
However, the results of these studies remain controversial, as the studies were relatively small in size and partially dif-
fered in design. We reviewed primary controlled randomized clinical studies comparing intracoronary transfer of autolo-
gous non-mobilized BMC combined with standard therapy versus standard therapy alone in patients with AMI. We iden-
tified five randomized controlled clinical trials, three of which were also placebo- and bone marrow aspiration-controlled.
Non-mobilized BMC were infused into the revascularized coronary target artery 6.6 ± 6.1 days after AMI. The mean fol-
low-up period of 5.2 ± 1.1 months was completed by 482 patients, 241 of which received infusion of BMC. The effect
of BMC on left ventricular ejection fraction (LVEF) as a major functional parameter was evaluated. Analyzing the over-
all effect on the change in LVEF between baseline and follow-up value revealed a significant improvement in the BMC-
treated group as compared to the control group (P = 0.04). Thus, considering the increase in LVEF during follow-up,
transplantation of BMC may be a safe and beneficial procedure to support treatment of AMI. However, the functional
improvement observed with this form of therapy was altogether relatively moderate and the studies were heterogeneous
in design. Hence, further efforts aiming at large-scale, double-blind, randomized and placebo-controlled multi-center tri-
als in conjunction with better definition of patients, which benefit from BMC infusion, appear to be warranted.
Keywords: myocardial infarction • revascularization • bone marrow • follow-up studies • meta-analysis
* Correspondence to: Prof. Christian WEBER
Institute for Molecular Cardiovascular Research, University
Hospital Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany
Tel.: +49 241 80 88692
Fax: +49 241 80 82716
Available online at
Journal of Cellular and Molecular Medicine
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J. Cell. Mol. Med. Vol 10, No 3, 2006