CD34+ cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent

Arshed A. Quyyumi, Edmund K. Waller, Jonathan R Murrow, Fabio Esteves, James Galt, John Oshinski, Stamatios Lerakis, Salman Sher, Douglas Vaughan, Emerson Perin, James Willerson, Dean Kereiakes, Bernard J. Gersh, Douglas Gregory, Astrid Werner, Thomas Moss, Wai Shun Chan, Robert Preti, Andrew L. Pecora

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Abstract

Background: The objective of the study was to determine whether the effects of infarct-related artery (IRA) infusion of autologous bone marrow-derived CD34+ cells after ST elevation myocardial infarction (STEMI) are dependent on the dose (quantity and mobility) of the cells infused. Beneficial effects of IRA infusion of mononuclear cells after STEMI have been inconsistent, possibly because of differences in timing, cell type, quantity, and mobility of infused cells. Methods: Patients were randomized to bone marrow harvest (n = 16) or control (n = 15). At a median of 8.3 days after coronary stenting for STEMI, CD34+ cells were infused via the IRA at 3 dose levels (5, 10, and 15 × 106) in cohorts of 5 patients each. Baseline and follow-up imaging and ex vivo CD34+ cell mobility were performed. Results: Cell harvest and infusion were safe. Quantitative rest hypoperfusion score measured by single-photon emission computed tomography improved at 6 months in the ≥10 million cohorts compared with controls (-256 vs +14, P = .02). There was a trend toward improved ejection fraction at 6 months (+4.5%) in the ≥10 million cohorts compared with no change in the controls and 5 million cohort (+0.7%). Improved perfusion and infarct size reduction correlated with the quantity and mobility of the infused CD34+ cells. Conclusions: The effects of CD34+ cell IRA infusion during the repair phase after STEMI are dose dependent and, at a threshold dose of 10 million CD34+ cells, associated with a significant improvement in perfusion that may limit deterioration in cardiac function (IRA infusion of CD34 + cells in patients with acute myocardial infarction [AMR-01] NCT00313339).

Original languageEnglish (US)
Pages (from-to)98-105
Number of pages8
JournalAmerican Heart Journal
Volume161
Issue number1
DOIs
StatePublished - Jan 1 2011
Externally publishedYes

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Perfusion
Arteries
ST Elevation Myocardial Infarction
Bone Marrow
Single-Photon Emission-Computed Tomography
Myocardial Infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

CD34+ cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent. / Quyyumi, Arshed A.; Waller, Edmund K.; Murrow, Jonathan R; Esteves, Fabio; Galt, James; Oshinski, John; Lerakis, Stamatios; Sher, Salman; Vaughan, Douglas; Perin, Emerson; Willerson, James; Kereiakes, Dean; Gersh, Bernard J.; Gregory, Douglas; Werner, Astrid; Moss, Thomas; Chan, Wai Shun; Preti, Robert; Pecora, Andrew L.

In: American Heart Journal, Vol. 161, No. 1, 01.01.2011, p. 98-105.

Research output: Contribution to journalArticle

Quyyumi, AA, Waller, EK, Murrow, JR, Esteves, F, Galt, J, Oshinski, J, Lerakis, S, Sher, S, Vaughan, D, Perin, E, Willerson, J, Kereiakes, D, Gersh, BJ, Gregory, D, Werner, A, Moss, T, Chan, WS, Preti, R & Pecora, AL 2011, 'CD34+ cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent', American Heart Journal, vol. 161, no. 1, pp. 98-105. https://doi.org/10.1016/j.ahj.2010.09.025
Quyyumi, Arshed A. ; Waller, Edmund K. ; Murrow, Jonathan R ; Esteves, Fabio ; Galt, James ; Oshinski, John ; Lerakis, Stamatios ; Sher, Salman ; Vaughan, Douglas ; Perin, Emerson ; Willerson, James ; Kereiakes, Dean ; Gersh, Bernard J. ; Gregory, Douglas ; Werner, Astrid ; Moss, Thomas ; Chan, Wai Shun ; Preti, Robert ; Pecora, Andrew L. / CD34+ cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent. In: American Heart Journal. 2011 ; Vol. 161, No. 1. pp. 98-105.
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abstract = "Background: The objective of the study was to determine whether the effects of infarct-related artery (IRA) infusion of autologous bone marrow-derived CD34+ cells after ST elevation myocardial infarction (STEMI) are dependent on the dose (quantity and mobility) of the cells infused. Beneficial effects of IRA infusion of mononuclear cells after STEMI have been inconsistent, possibly because of differences in timing, cell type, quantity, and mobility of infused cells. Methods: Patients were randomized to bone marrow harvest (n = 16) or control (n = 15). At a median of 8.3 days after coronary stenting for STEMI, CD34+ cells were infused via the IRA at 3 dose levels (5, 10, and 15 × 106) in cohorts of 5 patients each. Baseline and follow-up imaging and ex vivo CD34+ cell mobility were performed. Results: Cell harvest and infusion were safe. Quantitative rest hypoperfusion score measured by single-photon emission computed tomography improved at 6 months in the ≥10 million cohorts compared with controls (-256 vs +14, P = .02). There was a trend toward improved ejection fraction at 6 months (+4.5{\%}) in the ≥10 million cohorts compared with no change in the controls and 5 million cohort (+0.7{\%}). Improved perfusion and infarct size reduction correlated with the quantity and mobility of the infused CD34+ cells. Conclusions: The effects of CD34+ cell IRA infusion during the repair phase after STEMI are dose dependent and, at a threshold dose of 10 million CD34+ cells, associated with a significant improvement in perfusion that may limit deterioration in cardiac function (IRA infusion of CD34 + cells in patients with acute myocardial infarction [AMR-01] NCT00313339).",
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T1 - CD34+ cell infusion after ST elevation myocardial infarction is associated with improved perfusion and is dose dependent

AU - Quyyumi, Arshed A.

AU - Waller, Edmund K.

AU - Murrow, Jonathan R

AU - Esteves, Fabio

AU - Galt, James

AU - Oshinski, John

AU - Lerakis, Stamatios

AU - Sher, Salman

AU - Vaughan, Douglas

AU - Perin, Emerson

AU - Willerson, James

AU - Kereiakes, Dean

AU - Gersh, Bernard J.

AU - Gregory, Douglas

AU - Werner, Astrid

AU - Moss, Thomas

AU - Chan, Wai Shun

AU - Preti, Robert

AU - Pecora, Andrew L.

PY - 2011/1/1

Y1 - 2011/1/1

N2 - Background: The objective of the study was to determine whether the effects of infarct-related artery (IRA) infusion of autologous bone marrow-derived CD34+ cells after ST elevation myocardial infarction (STEMI) are dependent on the dose (quantity and mobility) of the cells infused. Beneficial effects of IRA infusion of mononuclear cells after STEMI have been inconsistent, possibly because of differences in timing, cell type, quantity, and mobility of infused cells. Methods: Patients were randomized to bone marrow harvest (n = 16) or control (n = 15). At a median of 8.3 days after coronary stenting for STEMI, CD34+ cells were infused via the IRA at 3 dose levels (5, 10, and 15 × 106) in cohorts of 5 patients each. Baseline and follow-up imaging and ex vivo CD34+ cell mobility were performed. Results: Cell harvest and infusion were safe. Quantitative rest hypoperfusion score measured by single-photon emission computed tomography improved at 6 months in the ≥10 million cohorts compared with controls (-256 vs +14, P = .02). There was a trend toward improved ejection fraction at 6 months (+4.5%) in the ≥10 million cohorts compared with no change in the controls and 5 million cohort (+0.7%). Improved perfusion and infarct size reduction correlated with the quantity and mobility of the infused CD34+ cells. Conclusions: The effects of CD34+ cell IRA infusion during the repair phase after STEMI are dose dependent and, at a threshold dose of 10 million CD34+ cells, associated with a significant improvement in perfusion that may limit deterioration in cardiac function (IRA infusion of CD34 + cells in patients with acute myocardial infarction [AMR-01] NCT00313339).

AB - Background: The objective of the study was to determine whether the effects of infarct-related artery (IRA) infusion of autologous bone marrow-derived CD34+ cells after ST elevation myocardial infarction (STEMI) are dependent on the dose (quantity and mobility) of the cells infused. Beneficial effects of IRA infusion of mononuclear cells after STEMI have been inconsistent, possibly because of differences in timing, cell type, quantity, and mobility of infused cells. Methods: Patients were randomized to bone marrow harvest (n = 16) or control (n = 15). At a median of 8.3 days after coronary stenting for STEMI, CD34+ cells were infused via the IRA at 3 dose levels (5, 10, and 15 × 106) in cohorts of 5 patients each. Baseline and follow-up imaging and ex vivo CD34+ cell mobility were performed. Results: Cell harvest and infusion were safe. Quantitative rest hypoperfusion score measured by single-photon emission computed tomography improved at 6 months in the ≥10 million cohorts compared with controls (-256 vs +14, P = .02). There was a trend toward improved ejection fraction at 6 months (+4.5%) in the ≥10 million cohorts compared with no change in the controls and 5 million cohort (+0.7%). Improved perfusion and infarct size reduction correlated with the quantity and mobility of the infused CD34+ cells. Conclusions: The effects of CD34+ cell IRA infusion during the repair phase after STEMI are dose dependent and, at a threshold dose of 10 million CD34+ cells, associated with a significant improvement in perfusion that may limit deterioration in cardiac function (IRA infusion of CD34 + cells in patients with acute myocardial infarction [AMR-01] NCT00313339).

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