Regenerative therapy in patients with a revascularized acute anterior myocardial infarction and depressed ventricular function

Introduction and objectives. It is difficult to distinguish the effects early revascularization and regenerative therapy have on left ventricular function in patients with acute myocardial infarction (AMI). This study was an investigation into three groups of patients who had a revascularized anterior wall AMI and depressed left ventricular function (i.e., ejection fraction < 45%). The aim was to compare changes in left ventricular function between patients who received regenerative therapy and those who did not. Methods. Patients were randomly assigned to receive either an intracoronary infusion of autologous mononuclear bone marrow cells (Group 1; n=10) or systemic administration of granulocyte colony-stimulating factor (G-CSF) (Group 11; n=10), or to a control group (Group III; n=10). In Group 1, intracoronary infusion was carried out 7(2) days after AMI. Group-II patients received a 10-day course of subcutaneous G-CSF injections, 10 mu g/kg per day starting 5 days after AMI. Ventricular function was assessed at baseline and 3-month follow-up. Results. A 20% increase in mean ejection fraction was observed in Group 1, compared with increases of 4% (P <.01) and 6% (P <.05) in Groups 11 and III, respectively. Conclusions. Intracoronary infusion of mononuclear bone marrow cells in patients with AMI and poor ventricular function was associated with better short-term functional recovery than previously reported. However, mobilization of stem cells by G-CSF did not have a significant influence on functional recovery.