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Stem cell therapy using patient's own cells after heart attack does not enhance cardiac recovery

Public release date: 6-Nov-2012 [ | E-mail | Share ]

Contact: Steve Goodyear sgoodyear@mhif.org 952-807-8365 Minneapolis Heart Institute Foundation

MINNEAPOLIS, MN November 6, 2012 Administering autologous stem cells obtained from bone marrow either 3 or 7 days following a heart attack did not improve heart function six months later, reports a new clinical trial supported by the National Institutes of Health. The results of this trial, called TIME (Transplantation In Myocardial Infarction Evaluation), were presented by Jay Traverse, MD of the Minneapolis Heart Institute Foundation Tuesday, Nov. 6, at the 2012 Scientific Sessions of the American Heart Association in Los Angeles.

The results of this trial mirror a previous, related study (LateTIME) which found that autologous bone marrow stem cell therapy given 2-3 weeks after a heart attack did not improve cardiac recovery. Both TIME and LateTIME were carried out by the Cardiovascular Cell Therapy Research Network (CCTRN), sponsored by the NIH's National Heart, Lung, and Blood Institute.

"The data presented by TIME do much to advance stem cell therapy research," said Jay Traverse, MD of the Minneapolis Heart Institute Foundation and Principal Investigator of this study. "While this study did not provide a demonstrated cardiac benefit after six months, we still learned a great deal. Together, TIME and Late TIME have shown that stem cell therapy is safe, and they have set a baseline in terms of quantity of stem cells, type of stem cells, and severity of heart attack."

TIME enrolled 120 volunteers (avg. age 57) between July 2008 and February 2011; the participants all had moderate to severe impairment in their left ventricle and had undergone coronary stent placement as treatment for the heart attack. The participants were randomly assigned to one of four groups: day 3 stem cell, day 3 placebo (inactive cells), day 7 stem cell, or day 7 placebo. The CCTRN researchers developed a method of processing and purifying the stem cells from the bone marrow of each volunteer to ensure everyone received a uniform dose (150 million stem cells).

Heart improvement was assessed six months after stem cell therapy by measuring the percentage of blood that gets pumped out of the left ventricle during each contraction (left-ventricular ejection fraction, or LVEF). The study found no significant differences between the change in LVEF readings at the six month follow-up in either the Day 3 or Day 7 stem cell groups compared with placebo or with each other; every group showed about a 3 percent improvement in LVEF. However, the researchers found that younger patients randomized to Day 7 had greater improvement in their LVEF compared to their placebo counterparts

"The lack of six-month improvement seen for TIME and, prior to that, LateTIME, does not mean stem cell therapy is not a viable post-heart attack strategy," said Traverse. "Because we have this data we can start to address some parameters; for example this therapy may work better in younger people, or maybe we need to use cells from healthy volunteers (allogeneic) since their cells may provide greater therapeutic benefit. There will also be upcoming studies using novel cell types which we look forward to using in future clinical trials."

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Stem cell therapy using patient's own cells after heart attack does not enhance cardiac recovery

Studies On Stem Cell Therapy After Heart Attack Show Mixed Results

April Flowers for redOrbit.com Your Universe Online

Conflicting studies were highlighted at this years American Heart Association Scientific Sessions meeting concerning stem cell therapy for heart attack patients.

The first study, from the University of Louisville and Brigham and Womens Hospital, reported holy grail results for a Phase I clinical trial: marked sustained improvement in all patients with zero adverse effects.

Roberto Bolli, M.D., of the University of Louisville and Piero Anversa, M.D., of Brigham and Womens Hospital presented data from their groundbreaking research in the use of autologous adult stem cells with patients who had previous heart attacks in a Late-Breaking Clinical Trial session.

The researchers report that all patients receiving the stem cell therapy showed improved heart function after two years, with an overall 12.9 absolute unit increase in left ventricular ejection fraction (LVEF). LVEF is a standard measure of heart function that shows the amount of blood ejected from the left ventricle during a heartbeat. They saw no adverse effects from the therapy. In fact, nine patients showed evidence of myocardial regeneration new tissue replacing formerly dead tissue killed by heart attack in MRI scans.

The trial shows the feasibility of isolating and expanding autologous stem cells from virtually every patient, said Bolli, who is the Jewish Hospital Heart and Lung Institute Distinguished Chair in Cardiology and director of the Institute for Molecular Cardiology in the Department of Medicine at UofL. The results suggest that this therapy has a potent, beneficial effect on cardiac function that warrants further study.

In all patients, cells with high regenerative reserve were obtained and employed therapeutically, said Anversa, professor of Anesthesia and Medicine at Brigham and Womens Hospital and Harvard Medical School. Our efforts to carefully characterize the phenotype and growth properties of the cardiac stem cells may have contributed to these initial positive results.

The Stem Cell Infusion in Patients with Ischemic CardiOmyopathy, or SCIPIO, trial was a randomized open-label trial of cardiac stem cells (CSCs) in patients who were diagnosed with heart failure following a myocardial infarction and had a LVEF of 40 percent or lower. A normal LVEF reading is 50 percent or higher.

The CSCs, referred to as c-kit positive cells because they express the c-kit protein on their surface, were harvested from 33 patients during coronary artery bypass surgery. The stem cells were then purified and processed so that they could multiply, and once an adequate number was produced about one million for each patient they were reintroduced into the region of the patients heart that suffered scarring during the heart attack.

At four months after infusion, the researchers report that LVEF increased from 29 percent to 36 percent for 200 patients. On average, the 13 control patients who did not receive a CSC infusion showed any improvement.

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Studies On Stem Cell Therapy After Heart Attack Show Mixed Results

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