Background Emerging evidence suggests that stem cells and progenitor ce lls der ived from bone marrow can be used to improve cardiac function in patients after acute myocardial infarction. In this randomised trial, we aimed to assess whethe r intracoronary transfer of autologous bone-marrow cells could improve global l eft-ventricular ejection fraction (LVEF) at 6 months’follow-up. Methods After successful percutaneous coronary intervention (PCI) for acute ST-segment eleva tion myocardial infarction, 60 patients were randomly assigned to either a contr ol group (n=30) that received optimum postinfarction medical treatment, or a bon e-marrow-cell group (n=30) that received optimum medical treatment and intraco ronary transfer of autologous bone-marrow cells 4.8 days (SD 1.3) after PCI. Pr imary endpoint was global left-ventricular ejection fraction (LVEF) change from baseline to 6 months’follow-up, as determined by cardiac MRI. Image analyses were done by two investigators blinded for treatment assignment. Analysis was pe r protocol. Findings Global LVEF at baseline (determined 3.5 days > after PCI) was 51.3 (9.3%) in controls and 50.0(10.0%) in the bone-marrow cell group (p=0.59). After 6 months, mean global LVEF had increased by 0.7 percentage points in the c ontrol group and 6.7 percentage points in the bone-marrow-cell group (p=0.0026 ). Transfer of bone-marrow cells enhanced left-ventricular systolic function p rimarily in myocardial segments adjacent to the infarcted area. Cell transfer di d not increase the risk of adverse clinical events, in-stent restenosis, or pro arrhythmic effects. Interpretation Intracoronary transfer of autologous bone-ma rrow-cells promotes improvement of left-ventricular systolic function in patie nts after acute myocardial infarction.
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