Sürder, DanielDanielSürderManka, RobertRobertMankaLo Cicero, VivianaVivianaLo CiceroMoccetti, TizianoTizianoMoccettiRufibach, KasparKasparRufibachSoncin, SabrinaSabrinaSoncinTurchetto, LuciaLuciaTurchettoRadrizzani, MarinaMarinaRadrizzaniAstori, GiuseppeGiuseppeAstoriSchwitter, JuergJuergSchwitterErne, PaulPaulErneZuber, MichelMichelZuberAuf der Maur, ChristophChristophAuf der MaurJamshidi, PeimanPeimanJamshidiGaemperli, OliverOliverGaemperliWindecker, StephanStephanWindeckerMoschovitis, ArisArisMoschovitisWahl, AndreasAndreasWahlBühler, InesInesBühlerWyss, ChristopheChristopheWyssKozerke, SebastianSebastianKozerkeLandmesser, UlfUlfLandmesserLüscher, Thomas FThomas FLüscherCorti, RobertoRobertoCorti2024-10-142024-10-142013-05-14https://boris-portal.unibe.ch/handle/20.500.12422/113464BACKGROUND Intracoronary administration of autologous bone marrow-derived mononuclear cells (BM-MNC) may improve remodeling of the left ventricle (LV) after acute myocardial infarction. The optimal time point of administration of BM-MNC is still uncertain and has rarely been addressed prospectively in randomized clinical trials. METHODS AND RESULTS In a multicenter study, we randomized 200 patients with large, successfully reperfused ST-segment elevation myocardial infarction in a 1:1:1 pattern into an open-labeled control and 2 BM-MNC treatment groups. In the BM-MNC groups, cells were administered either early (i.e., 5 to 7 days) or late (i.e., 3 to 4 weeks) after acute myocardial infarction. Cardiac magnetic resonance imaging was performed at baseline and after 4 months. The primary end point was the change from baseline to 4 months in global LV ejection fraction between the 2 treatment groups and the control group. The absolute change in LV ejection fraction from baseline to 4 months was -0.4±8.8% (mean±SD; P=0.74 versus baseline) in the control group, 1.8±8.4% (P=0.12 versus baseline) in the early group, and 0.8±7.6% (P=0.45 versus baseline) in the late group. The treatment effect of BM-MNC as estimated by ANCOVA was 1.25 (95% confidence interval, -1.83 to 4.32; P=0.42) for the early therapy group and 0.55 (95% confidence interval, -2.61 to 3.71; P=0.73) for the late therapy group. CONCLUSIONS Among patients with ST-segment elevation myocardial infarction and LV dysfunction after successful reperfusion, intracoronary infusion of BM-MNC at either 5 to 7 days or 3 to 4 weeks after acute myocardial infarction did not improve LV function at 4-month follow-up.enbone marrow–derived progenitor cellsmagnetic resonance imagingmyocardial infarctionregenerationventricular remodeling600 - Technology::610 - Medicine & healtharticle10.7892/boris.416782359600610.1161/CIRCULATIONAHA.112.001035