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Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction

Final one-year results of the TOPCARE-AMI Trial

Volker Schächinger, MD^*, Birgit Assmus, MD^*, Martina B. Britten, MD^*, Jörg Honold, MD^*, Ralf Lehmann, MD^*, Claudius Teupe, MD^*, Nasreddin D. Abolmaali, MD, Thomas J. Vogl, MD, Wolf-Karsten Hofmann, MD, Hans Martin, MD, Stefanie Dimmeler, PhD^* and Andreas M. Zeiher, MD^*,*

^* Department of Cardiology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
Department of Radiology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany
Department of Hematology, Johann Wolfgang Goethe-University Frankfurt, Frankfurt, Germany

View larger version (24K): [in a new window]   Figure 1 Trial design (see text for details). AMI = acute myocardial infarction; BMC = bone marrow-derived progenitor cells; CPC = circulating progenitor cells; LV = left ventricular; MI = myocardial infarction; MRI = magnetic resonance imaging; PCI = percutaneous coronary intervention.

View larger version (13K): [in a new window]   Figure 2 Event-free survival of death, recurrent myocardial infarction, or target vessel revascularization (Kaplan-Meier analysis).

View larger version (18K): [in a new window]   Figure 3 Left ventricular ejection fraction, measured by quantitative left ventricular angiography initially and at four-month follow-up for patients receiving circulating progenitor cells (CPC) or bone marrow-derived progenitor cells (BMC). Bars represent mean ± SD.

View larger version (16K): [in a new window]   Figure 4 Correlation between initial global left ventricular ejection fraction and improvement of ejection fraction (difference between absolute values) during four-month follow-up (both assessed by quantitative left ventricular angiography). BMC = bone marrow-derived progenitor cells; CPC = circulating progenitor cells.

View larger version (18K): [in a new window]   Figure 5 Improvement of global left ventricular ejection fraction after four months assessed by quantitative left ventricular angiography according to the presence or absence of contractile reserve by low-dose stress echocardiography before intracoronary progenitor cell infusion. AMI = acute myocardial infarction.

View larger version (41K): [in a new window]   Figure 6 Magnetic resonance imaging (MRI)-determined improvement in global left ventricular ejection fraction (A) and reduction in late enhancement volume (B) after 4 and 12 months.