Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Bone-marrow-derived progenitor cell therapy in need of proof of concept: design of the REPAIR-AMI trial

Nature Clinical Practice Cardiovascular Medicine volume 3, pages S23–S28 (2006)Cite this article

Abstract

Early reperfusion of occluded coronary arteries has significantly reduced early mortality and improved the long-term prognosis of patients with an acute myocardial infarction. However, the development of postinfarction heart failure remains a major challenge. Initial experimental studies indicated that mononuclear progenitor cells derived from the bone marrow may contribute to the functional regeneration of freshly infarcted myocardium and increase neovascularization of ischemic areas. A number of clinical pilot trials have now transferred the experimental approach into the clinical arena, aiming at regenerating myocardial function with infusion of bone-marrow-derived progenitor cells in patients after an acute myocardial infarction. While these initial trials using intracoronary infusion of bone-marrow-derived progenitor cells indeed suggested that such a strategy appears to be feasible and safe in patients with an acute myocardial infarction, there is definitely a pressing need for a proof-of-concept study documenting a potentially beneficial effect of progenitor cell therapy on cardiac function.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Study design for REPAIR-AMI trial

Similar content being viewed by others

References

  1. Orlic D et al. (2001) Bone marrow cells regenerate infarcted myocardium. Nature 410: 701–705

    Article  CAS  Google Scholar 

  2. Kocher AA et al. (2001) Neovascularization of ischemic myocardium by human bone-marrow-derived angioblasts prevents cardiomyocyte apoptosis, reduces remodeling and improves cardiac function. Nat Med 7: 430–436

    Article  CAS  Google Scholar 

  3. Strauer BE et al. (2002) Repair of infarcted myocardium by autologous intracoronary mononuclear bone marrow cell transplantation in humans. Circulation 106: 1913–1918

    Article  Google Scholar 

  4. Wollert KC et al. (2004) Intracoronary autologous bone-marrow cell transfer after myocardial infarction: the BOOST randomised controlled clinical trial. Lancet 364: 141–148

    Article  Google Scholar 

  5. Fernández-Avilés F et al. (2004) Experimental and clinical regenerative capability of human bone marrow cells after myocardial infarction. Circ Res 95: 742–748

    Article  Google Scholar 

  6. Schächinger V et al. (2004) Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction: final one-year results of the TOPCARE-AMI trial. J Am Coll Cardiol 44: 1690–1699

    Article  Google Scholar 

  7. Montalescot G et al. (2001) Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction. N Engl J Med 344: 1895–1903

    Article  CAS  Google Scholar 

  8. Stone GW et al. (2002) Comparison of angioplasty with stenting, with or without abciximab, in acute myocardial infarction. N Engl J Med 346: 957–966

    Article  CAS  Google Scholar 

  9. Criteria Committee of the New York Heart Association (1994) Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels, edn 9, 253–256. Boston: Little, Brown

  10. Dodge HT et al. (1960) The use of biplane angiography for the measurement of left ventricular volume in man. Eur Heart J 60: 762–776

    CAS  Google Scholar 

  11. Sheehan FH et al. (1986) Advantages and applications of the centerline method for characterizing regional ventricular function. Circulation 74: 293–305

    Article  CAS  Google Scholar 

  12. Assmus B et al. (2002) Transplantation of Progenitor Cells and Regeneration Enhancement in Acute Myocardial Infarction (TOPCARE-AMI). Circulation 106: 3009–3017

    Article  Google Scholar 

  13. Anon (1985) The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. TIMI Study Group. N Engl J Med 312: 932–936

    Google Scholar 

Download references

Acknowledgements

The Clinical Studies Coordinating Center (CSCC) of the Department of Cardiology, Johann Wolfgang Goethe University, Frankfurt, supported trial logistics. The Institute for Transfusion Medicine financed production and transportation of bone marrow aspirate and trial medication. The following nonprofit research organizations supported preliminary research: Alfried Krupp Stiftung, the German Research Foundation, and the European Vascular Genomics Network. Guidant provided balloon catheters, and an unrestricted research grant. Lilly provided abciximab.

Author information

Authors and Affiliations

  1. Institute for Transfusion Medicine,

    Volker Schächinger, Torsten Tonn, Stefanie Dimmeler & Andreas M Zeiher

  2. Division of Molecular Cardiology,

    Volker Schächinger, Torsten Tonn, Stefanie Dimmeler & Andreas M Zeiher

  3. Department of Internal Medicine III/Cardiology, Johann Wolfgang Goethe University of Frankfurt, Frankfurt, Germany

    Volker Schächinger, Torsten Tonn, Stefanie Dimmeler & Andreas M Zeiher

Authors
  1. Volker Schächinger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Torsten Tonn
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Stefanie Dimmeler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Andreas M Zeiher
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andreas M Zeiher.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schächinger, V., Tonn, T., Dimmeler, S. et al. Bone-marrow-derived progenitor cell therapy in need of proof of concept: design of the REPAIR-AMI trial. Nat Rev Cardiol 3 (Suppl 1), S23–S28 (2006). https://doi.org/10.1038/ncpcardio0441

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpcardio0441

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing