Intracoronary infusion of Wharton’s jelly–derived mesenchymal stem cells after acute myocardial infarction (AMI) significantly reduced the risk of developing heart failure (HF) and related adverse cardiovascular events, suggesting its potential as a valuable adjunctive therapy. In a Iranian phase 3 randomized clinical trial involving 420 patients with a first ST-segment elevation AMI and left ventricular ejection fraction <40%, participants received either standard care alone or an intracoronary infusion of allogenic mesenchymal stem cells within 3–7 days of AMI. Among 396 patients analyzed over a median follow-up of 33.2 months, the intervention group showed a markedly lower incidence of HF (2.77 vs. 6.48 per 100 person-years; hazard ratio [HR], 0.43), fewer hospital readmissions for HF (0.92 vs. 4.20 per 100 person-years; HR, 0.22), and a reduced composite of cardiovascular mortality or readmission for AMI or HF (2.80 vs. 7.16 per 100 person-years; HR, 0.39). Although no significant effects were observed for AMI recurrence, all-cause mortality, or cardiovascular mortality, the intervention group experienced a significantly greater improvement in left ventricular ejection fraction at six months (β=5.88). These findings are in line with a previous trial of intracoronary infusion of bone marrow derived mononuclear cells, and highlight the therapeutic promise of mesenchymal stem cell infusion in mitigating post-infarction HF and enhancing cardiac recovery. Source: https://www.bmj.com/
