Long term follow-up of coronary artery bypass grafting with autologous bone marrow cell therapy

Background: Autologous bone marrow cell (BMC) therapy as an adjunct to coronary revascularization has been performed for many years. A randomized study was conducted using epicardial delivery to inject the BMC into the myocardium as an adjuvant to coronary revascularization (CABG) therapy in patients with decreased myocardial function. Methods: Autologous bone marrow cells was performed in patients with an ejection fraction of less than 35% undergoing CABG. The patients underwent echocardiography, nuclear imaging, and cardiac catheterization to identify ischemic regions of the heart and to guide in the selection of BMC injection sites. The patients were prospectively randomized before the operative therapy was performed. Patient follow-up was yearly after the initial year. Results: There were 50 patients enrolled in the study: 20 in the pilot phase and 30 in the second phase after safety was evaluated and verified. Twenty-five patients had successful BMC injection into the myocardium + CABG. The other 25 patients had CABG only. There were no complications attributed to the BMC. The patients have been followed for 10 years. There is a improvement in cardiac function over the 10 years compared to the control group (see table). There is also a survival advantage in the BMC group (22 pts) vs control (15 pts)∗ (∗p<0.05). Conclusions: Long term follow-up demonstrates that autologous BMC led to significant improvement in myocardial function with survival advantage. Larger studies will be required to further validate the findings of this study. Tabled 1Long term ventricular function Ejection Fraction % CABG CABG +BMC 1 yr 36.8 46.0 5 yr 34.0 43.1∗ 10 yr 29.8 37.2∗ ∗p<0.05. Open table in a new tab ∗p<0.05.