0
Letters |

Intracoronary Bone Marrow Mononuclear Cells After Myocardial Infarction—Reply

Jay H. Traverse, MD; Timothy D. Henry, MD; Carl J. Pepine, MD
JAMA. 2012;307(10):1022-1024. doi:10.1001/jama.2012.280.
Text Size: A A A
Published online

Extract

In Reply: We support Dr Ly's comments on the importance of patient selection in these trials. We elected to include patients with large infarcts from lesions in non–left anterior descending coronary arteries to facilitate enrollment, but only 5 patients had non–anterior MIs. Their inclusion did not appear to influence outcomes because the results were similar when analyzed without these patients. We have no evidence suggesting our patients had other forms of cardiomyopathy contributing to the reduced LVEF on qualifying echocardiogram (mean [SD], 36.4% [6.5%]) within 48 hours of their PCI. When measured at the time of the intracoronary infusion several weeks later, LVEF had increased (mean [SD], 44.3% [8.4%]) likely due to resolution of myocardial stunning. Still, it remained below the baseline median of 48.9% seen in the Reinfusion of Enriched Progenitor Cells and Infarct Remodeling in Acute Myocardial Infarction (REPAIR-AMI) study in which the greatest benefit of BMCs on LVEF recovery was observed.1 We agree that patients with persistent LV dysfunction after MI (LVEF <35%) constitute an important target for future studies that should include new cell types and delivery methods such as intramyocardial or transcoronary delivery. We are currently performing more detailed MRI analyses to address the extent of infarct transmurality and microvascular obstruction that may also influence outcomes.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

March 14, 2007
Samy Suissa, PhD
JAMA. 2007;297(10):1057-1058. doi:10.1001/jama.297.10.1057-a.
March 14, 2007
Wayne Gerard, MD; Julia Gerard, BS
JAMA. 2007;297(10):1057-1058. doi:10.1001/jama.297.10.1057-b.
March 14, 2012
Hung Q. Ly, MD, MSc, FRCPC
JAMA. 2012;307(10):1022-1024. doi:10.1001/jama.2012.278.
March 14, 2012
Arshed Quyyumi, MD, FRCP; Andrew L. Pecora, MD
JAMA. 2012;307(10):1022-1024. doi:10.1001/jama.2012.279.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs
brightcove.createExperiences();