Cell therapy fails to increase resting perfusion recovery

Cell therapy does not better the recovery of resting perfusion in the myocardial infarction (MI) core or border zone after revascularization of acute ST-elevation MI (STEMI), according to a study published in Radiology.

Though revascularization strategies such as percutaneous coronary intervention (PCI) and pharmacologic therapy have significantly lowered patient mortality rates after acute STEMI, long-term morbidity is still high, according to lead author Lourens F. H. J. Robbers, MD, of the VU University Medical Center in Amsterdam, and colleagues. The authors examined the effects of cell therapy on myocardial perfusion recovery after the treatment of acute MI with primary PCI.

Comprised of 152 patients between the ages of 30 and 75 with first STEMI, the study randomized patients into three groups after undergoing MRI: intracoronary infusion of autologous bone marrow-derived mononuclear cells, intracoronary infusion of autologous peripheral blood-derived mononuclear cells, and a control group with standard medical therapy.

After additional imaging at a four-month follow up, it was determined that myocardial perfusion differed between the MI core, border zone and remote myocardium with an equal distribution across treatment groups at medians of 6, 8.4, and 12.2 percent, respectively. Interregional differences were still observed at follow-up. The researchers found no difference in perfusion recovery between the three treatment groups for any region.

“Intracoronary infusion of either bone marrow–derived mononuclear cells or peripheral blood–derived mononuclear cells does not augment the restoration of either MI core or border zone perfusion after revascularization of [STEMI],” concluded Robbers and colleagues.