Autologous Bone Marrow Cell Therapy in Acute Myocardial Infarction Trial - BAMI

Aug 30, 2020
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Author/Summarized by Author:
Anthony A. Bavry, MD, MPH, FACC
Summary Reviewer:
Deepak L. Bhatt, MD, MPH, FACC
Trial Sponsor:
European Commission under the 7th Framework Programme
Date Presented:
08/30/2020
Date Published:
08/29/2020
Original Posted Date:
08/30/2020
References

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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