Identification of cardiovascular risk factors associated with bone marrow cell subsets in patients with STEMI: a biorepository evaluation from the CCTRN TIME and LateTIME clinical trials

Autologous bone marrow mononuclear cell (BM-MNC) therapy for patients with ST-segment elevation myocardial infarction (STEMI) has produced inconsistent results, possibly due to BM-MNC product heterogeneity. Patient-specific cardiovascular risk factors (CRFs) may contribute to variations in BM-MNC composition. We sought to identify associations between BM-MNC subset frequencies and specific CRFs in STEMI patients. Bone marrow was collected from 191 STEMI patients enrolled in the CCTRN TIME and LateTIME trials. Relationships between BM-MNC subsets and CRFs were determined with multivariate analyses. An assessment of CRFs showed that hyperlipidemia and hypertension were associated with a higher frequency of CD11b(+) cells (P = 0.045 and P = 0.016, respectively). In addition, we found that females had lower frequencies of CD11b(+) (P = 0.018) and CD45(+)CD14(+) (P = 0.028) cells than males, age was inversely associated with the frequency of CD45(+)CD31(+) cells (P = 0.001), smoking was associated with a decreased frequency of CD45(+)CD31(+) cells (P = 0.013), glucose level was positively associated with the frequency of CD45(+)CD3(+) cells, and creatinine level (an indicator of renal function) was inversely associated with the frequency of CD45(+)CD3(+) cells (P = 0.015). In conclusion, the frequencies of monocytic, lymphocytic, and angiogenic BMMNCs varied in relation to patients' CRFs. These phenotypic variations may affect cell therapy outcomes and might be an important consideration when selecting patients for and reviewing results from autologous cell therapy trials.