Stem Cell Therapy To Prevent Heart Attacks
Main Category: Stem Cell Research
Also Included In: Cardiovascular / Cardiology
Article Date: 29 Jun 2007 - 1:00 PST
The use of stem cell therapy to prevent heart attacks is explored in
a Comment published in this week's edition of The Lancet.
Professor Harald Arnesen and colleagues from the Ullevål University
Hospital, Oslo, Norway looked at studies published to date on the
relatively new technique of using of autologous cells derived from
bone marrow cells (BMC) to strengthen cardiac function. Autologous
cells are sourced from the patient they are used to treat. The
authors refer to a trial done in 2002 in which such cells were
administered into the heart with encouraging results.
The authors say: "The results of this and several other small
uncontrolled studies with the same method were encouraging. However,
three randomised trials that tested therapy with BMC were negative
for the primary endpoint, improvement in left ventricular ejection-
fraction (LVEF)."
A trial of 204 patients (REPAIR-AMI) is also discussed by the Comment
authors. Half of these patients were randomised to receive an
intracoronary infusion of BMC, or placebo. LVEF increased slightly in
the placebo group (47% to 50%) and slightly more in the BMC group
(47% to 54%). Despite this modest difference, there was a significant
reduction in clinical events in the BMC group compared to placebo-
namely that the combined risk of death, heart attack or
revascularisation fell by nearly half. Investigators involved in
REPAIR-AMI concluded that the results warranted large-scale trials to
study effects of BMC infusion on morbidity and mortality.
The authors are concerned about this, because they feel that the
methods for measurement of LVEF in REPAIR-AMI were not ideal, and
that the positive clinical effect in that trial was driven by poor
outcome in the placebo group.
They conclude: "Further research will hopefully develop cell-based
treatments that can improve prognosis and quality of life for
patients with cardiac diseases. However, because only a small
treatment effect has been obtained with inaccurate methods, and
because there is reason to question the safety of the placebo
procedure in REPAIR-AMI, we think it is inappropriate to invite a
large number of patients to participate in new studies based on the
methods used in that investigation.
http://www.lancet.
http://www.medicaln
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The CNS Healing Group
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