Autologous Bone Marrow Cell Therapy in Acute Myocardial Infarction Trial - BAMI
Contribution To Literature:
The BAMI trial failed to show that bone marrow-derived mononuclear cell intracoronary therapy was superior to standard therapy.
Description:
The goal of the trial was to evaluate bone marrow-derived mononuclear cell intracoronary injection compared with standard therapy among patients who underwent reperfusion for acute myocardial infarction.
Study Design
- Randomized
- Parallel
- Open-label
Eligible patients were randomized to bone marrow-derived mononuclear cell intracoronary infusion (n = 185) versus standard therapy (n = 190).
- Total number of enrollees: 375
- Duration of follow-up: 2 years
- Mean patient age: 59 years
- Percentage female: 19%
- Percentage with diabetes: 16%
Inclusion criteria:
- Acute myocardial infarction with successful reperfusion
- Left ventricular ejection fraction (LVEF) ≤45%
Other salient features/characteristics:
- Culprit vessel was left anterior descending in 86%
- Core lab LVEF 39%
Principal Findings:
The primary outcome, all-cause death at 2 years, occurred in 3.3% of the bone-marrow-derived mononuclear cell group compared with 3.8% of the standard care group (p = 0.77).
Secondary outcomes:
- Cardiovascular death or hospitalization due to heart failure: 4.9% with the bone-marrow-derived mononuclear cell group compared with 9.7% of the standard care group (p = nonsignificant)
Interpretation:
Among patients with ST-segment elevation myocardial infarction who underwent reperfusion, bone marrow-derived mononuclear cell coronary injection failed to improve all-cause mortality, or death/heart failure hospitalization. Similar trials on the topic have also failed to show a benefit from stem cell therapy.
References:
Mathur A, Fernández-Avilés F, Bartunek J, et al. The effect of intracoronary infusion of bone marrow-derived mononuclear cells on all-cause mortality in acute myocardial infarction: the BAMI trial. Eur Heart J 2020;Aug 29:[Epub ahead of print].
Presented by Dr. Anthony Mathur at the European Society of Cardiology Virtual Congress, August 30, 2020.
Keywords: ESC Congress, ESC20, Acute Coronary Syndrome, Bone Marrow, Bone Marrow Cells, Heart Failure, Myocardial Infarction, ST Elevation Myocardial Infarction, Myocardial Reperfusion, Stem Cell Transplantation, Stroke Volume, Ventricular Function, Left
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