{"id":"1e330f23431e","type":"article","url":"https://hartvaat.nl/2016/06/01/herhaalde-intracoronaire-beenmergcelinjectie-bij-hartfalen-resultaten-uit-een-re/","title":"Herhaalde intracoronaire beenmergcelinjectie bij hartfalen: resultaten uit een register","title_en":"Improved outcome with repeated intracoronary injection of bone marrow-derived cells within a registry: rationale for the randomized outcome trial REPEAT.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":["acuut-hartfalen","hfref","ijzersuppletie","ivabradine"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehv559","source_url":"https://doi.org/10.1093/eurheartj/ehv559","authors":["Birgit Assmus","Samer Alakmeh","Salvatore De Rosa","Halvard Bönig","Eva Hermann","Wayne C Levy","Stefanie Dimmeler","Andreas M Zeiher"],"significance":5,"published":"2016-06-01","source_date":"2016-06-01","image":"","kennis":[],"congress":"","summary_en":"This registry analysis suggested that repeated intracoronary bone marrow cell injections improve outcomes in post-infarction heart failure, providing the rationale for a dose-escalation approach to cardiac regenerative therapy.","created":"2026-07-03T10:26:09Z","updated":"2026-07-03T18:38:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Registeranalyse die verbeterde uitkomsten toont bij herhaalde intracoronaire beenmergcelinjecties bij hartfalen. Biedt rationale voor de gerandomiseerde REPEAT-trial.","abstract_original":"AIMS: Regenerative therapies have evolved as a promising new option in the treatment of post-infarction heart failure. A major limitation of intracoronary application of autologous bone marrow-derived mononuclear cells (BM-MNCs) is that homing of the applied cells is profoundly reduced in patients with post-infarction heart failure compared with patients with acute myocardial infarction. However, early pilot and also randomized controlled trials have demonstrated significant improvements in overall cardiac function. The aim of the present analysis was to quantify a potential mortality risk reduction and reduced hospitalization in order to provide data for a prospective outcome trial. METHODS AND RESULTS: The results of an ongoing single-centre registry including 297 post-infarction heart failure patients suggest that repeated intracoronary application of autologous bone marrow-derived cells is associated with a significant better 2-year survival compared with a single BM-MNC application (2-year survival 93.6 vs. 84.0%, P = 0.03). Likewise, mortality is significantly lower at 2-year follow-up compared with the mortality estimated by the use of the Seattle Heart Failure Model (SHFM) in patients receiving repeated BM-MNC application (observed mortality 6.4%, predicted mortality 16.2%, P = 0.02). Although the trend persisted at 3-year follow-up, the mortality reduction was no longer statistically significant between single and repeated treatment (mortality 21.9 vs. 13.7%, P = 0.06). CONCLUSION: Repeated intracoronary administration of BM-MNC appears to be associated with improved clinical outcome compared with single treatment at 2 years. This registry provides the rationale for the design of the multicentre randomized, controlled, open-label REPEAT trial, which prospectively compares the effects of single vs. repeated intracoronary application of autologous BM-MNC on total and SHFM-predicted mortality in patients with chronic post-infarction heart failure."}