Impact of intracoronary injection of CD133+ bone marrow stem cells on coronary atherosclerotic progression in patients with STEMI

Abstract

Intracoronary injection of CD133(+) bone marrow stem cells has no IVUS-detectable effect on neointimal hyperplasia or atherosclerosis progression in either infarct-related or contralateral arteries.

Transcoronary stem cell transfer and evolution of infarct-related artery atherosclerosis: evaluation with conventional and novel imaging techniques including Quantitative Virtual Histology (qVH)

“…IRA analysis revealed similar changes in distal nonstented segment plaque burden between the stem cell and placebo groups (B/L – 41.9 vs. 37.4%, p = 0.56; F/U – 46.7 vs. 40.9%, p = 0.17) [ 44 ]. Findings also were similar for the distal non-culprit segment in patients receiving vs. not receiving stem cells [ 44 ]. Furthermore, in the contralateral coronary artery, there were no differences in changes in MLA, plaque burden, or attenuated plaque between stem cell and placebo patients [ 44 ].…”

“…Furthermore, in the contralateral coronary artery, there were no differences in changes in MLA, plaque burden, or attenuated plaque between stem cell and placebo patients [ 44 ]. The authors concluded that intracoronary injection of CD133 + bone marrow stem cells had no IVUS-detectable effect on neointimal hyperplasia or atherosclerosis progression in either IRA or contralateral arteries [ 44 ]. In aggregate, these studies [ 9 , 44 ] taken together with our present results ( Tables II – IV ) refute early data by Vanderheyden et al [ 15 ] and Mansour et al [ 16 ].…”

“…The authors concluded that intracoronary injection of CD133 + bone marrow stem cells had no IVUS-detectable effect on neointimal hyperplasia or atherosclerosis progression in either IRA or contralateral arteries [ 44 ]. In aggregate, these studies [ 9 , 44 ] taken together with our present results ( Tables II – IV ) refute early data by Vanderheyden et al [ 15 ] and Mansour et al [ 16 ]. Moreover, our findings indicate regression of IRA atherosclerosis ( Tables II – IV ) in patients subjected to delivery of progenitor/stem cells via the IRA.…”

“…Other limitations include our lack of evaluation of non-IRA arteries. However, any stem cell-mediated effects on non-IRA coronary arteries are not only unlikely with trans-IRA cell delivery [ 44 ], and those would be expected to occur similarly in arteries other than the coronaries. Axial resolution of IVUS (≈120 µm in 20-MHz transducers) is rather poor in relation to OCT [ 65 ].…”

“…Recent work by the teams of Assmus et al [9] and Qiu et al [44] provides some evidence against any relevant pro-athrosclerotic effect of transcoronary-administered stem/progenitor cells in patients with AMI. Retrospective QCA measurements of the infarct target vessel in 83 patients with AMI treated with stent-assisted PCI (a control group) and in 83 patients receiving additional intracoronary progenitor cell infusion at 5 days post pPCI, with coronary angiography repeated at 4 months, showed that the late loss as a measure of neointima formation was similar between the control and the cell-treated group at follow-up (0.9 ±0.8 vs. 0.9 ±0.7 mm, p = 0.9) [9].…”