Intracoronary injection of CD133-positive enriched bone marrow progenitor cells promotes cardiac recovery after recent myocardial infarction - Feasibility and safety

Background-Bone marrow CD133-postive (CD133(+)) cells possess high hematopoietic and angiogenic capacity. We tested the feasibility, safety, and functional effects of the use of enriched CD133(+) progenitor cells after intracoronary administration in patients with recent myocardial infarction. Methods and Results-Among 35 patients with acute myocardial infarction treated with stenting, 19 underwent intracoronary administration of CD133(+) progenitor cells (12.6 +/- 2.2X 10(6) cells) 11.6 +/- 1.4 days later (group 1) and 16 did not (group 2). At 4 months, left ventricular ejection fraction increased significantly in group I (from 45.0 +/- 2.6% to 52.1 +/- 3.5%, P < 0.05), but only tended to increase in case-matched group 2 patients (from 44.3 +/- 3.1% to 48.6 +/- 3.6%, P = NS). Likewise, left ventricular regional chordae shortening increased in group 1 (from 11.5 +/- 1.0% to 16.1 +/- 1.3 %, P< 0.05) but remained unchanged in group 2 patients (from 11.1 +/- 1.1% to 12.7 +/- 1.3 %, P = NS). This was paralleled by reduction in the perfusion defect in group 1 (from 2 8.0 +/- 4.1% to 22.5 +/- 4. 1 %, P < 0.05) and no change in group 2 (from 25.0 +/- 3.0% to 22.6 +/- 4.1%, P=NS). In group 1, two patients developed in-stent reocclusion, 7 developed in-stent restenosis, and 2 developed significant de novo lesion of the infarct-related artery. In group 2, four patients showed in-stent restenosis. In group 1 patients without reocclusion, glucose uptake shown by positron emission tomography with (18)fluorodeoxyglucose in the infarct-related territory increased from 51.2 +/- 2.6% to 57.5 +/- 3.5% (P < 0.05). No stem cell-related arrhythmias were noted, either clinically or during programmed stimulation studies at 4 months. Conclusion-In patients with recent myocardial infarction, intracoronary administration of enriched CD133(+) cells is feasible but was associated with increased incidence of coronary events. Nevertheless, it seems to be associated with improved left ventricular performance paralleled with increased myocardial perfusion and viability.