RT Journal
A1 Ly HQ
T1 INtracoronary bone marrow mononuclear cells after myocardial infarction
JF JAMA
JO JAMA
YR 2012
FD March 14
VO 307
IS 10
SP 1022
OP 1024
DO 10.1001/jama.2012.278
UL http://dx.doi.org/10.1001/jama.2012.278
AB 
While timing can affect efficacy of cardiac cell-based therapies, patient selection remains of paramount importance. It is unclear why patients with lesions in coronary arteries other than the left anterior descending (4 right coronary arteries and 1 left circumflex coronary artery, all in the intervention group) were included. Because the mean qualifying LV ejection fraction (LVEF) was 35% to 36%, could a mixed cardiomyopathy have explained the initial LV dysfunction and thus partly biased the efficacy findings in cell-treated patients? Moreover, was consideration given to including only patients with anterior wall MIs associated with severe but persistent LV dysfunction (ie, LVEF ≤35% at baseline and not just at screening), who would be more likely to benefit from BMC injection relative to a population with only moderate LV impairment? While more likely to induce recruitment delays, such a strategy might have resulted in greater benefit in the intervention group.