Document Detail


Clinical use of intracoronary gene transfer of fibroblast growth factor for coronary artery disease.
MedLine Citation:
PMID:  15180588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Anginal symptoms due to myocardial ischemia continue to affect millions of patients despite ongoing improvements in the diagnosis and treatment of coronary artery disease. Revascularization therapy with percutaneous coronary interventions and coronary artery bypass graft surgery can be highly effective in eligible subjects, but many patients are suboptimal candidates due to various factors, which include diffuse vascular disease, poor ventricular function and failure of prior procedures. Introduction of vascular growth factors to the heart to promote angiogenesis and collateral vessel formation has emerged as an alternative strategy for the relief of myocardial ischemia in these patients. Early preclinical work demonstrated that gene transfer of fibroblast growth factor using an E1-deleted adenovirus vector via intracoronary injection could safely reverse stress-induced ischemic ventricular dysfunction with no discernible evidence of inflammatory response. The AGENT trial established that intracoronary administration of Ad5FGF-4 could be performed with reasonable safety to patients with coronary artery disease, and that a one-time dose could provide an anti-ischemic effect out to 12 weeks of evaluation. Further evaluation of the efficacy and safety of Ad5FGF-4 is now being conducted in two simultaneous multicenter, randomized, double-blind, placebo-controlled pivotal trials in the United States and the European Union, with planned enrollment of approximately 1000 treated subjects. The primary efficacy variable in the trial will be changed in treadmill exercise duration at 12 weeks compared to baseline. Secondary efficacy variables include the rate of all-cause mortality and coronary events (non-fatal myocardial infarction, and unplanned hospitalization and revascularization due to myocardial ischemia) up to 1 year.
Authors:
W F Penny; H Kirk Hammond
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current gene therapy     Volume:  4     ISSN:  1566-5232     ISO Abbreviation:  Curr Gene Ther     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-06-07     Completed Date:  2005-02-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  101125446     Medline TA:  Curr Gene Ther     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  225-30     Citation Subset:  IM    
Affiliation:
Division of Cardiology, VA San Diego Healthcare System and University of California, San Diego School of Medicine, San Diego, California 92161, USA. wpenny@ucsd.edu
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MeSH Terms
Descriptor/Qualifier:
Adenoviridae / genetics
Coronary Artery Disease / genetics*,  pathology,  therapy*
Fibroblast Growth Factors / genetics*,  metabolism,  therapeutic use*
Gene Therapy / methods*
Humans
Ischemia / genetics,  pathology,  therapy
Chemical
Reg. No./Substance:
62031-54-3/Fibroblast Growth Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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