Document Detail


Procedural Safety and Predictors of Acute Outcome of Intracoronary Administration of Progenitor Cells in 775 Consecutive Procedures Performed for Acute Myocardial Infarction or Chronic Heart Failure.
MedLine Citation:
PMID:  23362308     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: CELL-BASED THERAPIES ARE A PROMISING OPTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION OR CHRONIC HEART FAILURE (CHF). HOWEVER, ADMINISTRATION OF CELLS REQUIRES INTRACORONARY OR INTRACARDIAC INSTRUMENTATION, WHICH IS POTENTIALLY ASSOCIATED WITH PERIPROCEDURAL RISKS. THEREFORE, WE ANALYZED PERIPROCEDURAL COMPLICATIONS AND 30-DAY OUTCOME IN 775 CONSECUTIVE PROCEDURES OF INTRACORONARY ADMINISTRATION OF PROGENITOR CELLS USING THE STOP-FLOW TECHNIQUE.METHODS AND RESULTS: INDICATIONS FOR CELL ADMINISTRATION WERE ACUTE MYOCARDIAL INFARCTION (N=126) AND CHF OF ISCHEMIC (N=562) OR NONISCHEMIC (N=87) ETIOLOGY. VESSEL INJURY WAS OBSERVED IN A TOTAL OF 9 PROCEDURES (1.2%) AND COULD BE PROMPTLY MANAGED BY ADDITIONAL PROGENITOR CELL INJECTION (PCI) IN ALL BUT 1 CASE. NO PROCEDURAL DEATHS WERE OBSERVED. A PERIPROCEDURAL INCREASE IN TROPONIN T WAS OBSERVED IN 3.2% OF THE CHF PROCEDURES, IN WHICH NO CONCOMITANT PCI WAS PERFORMED AND TROPONIN LEVELS WERE NOT ELEVATED BEFORE THE PROCEDURE. INDEPENDENT SIGNIFICANT PREDICTORS OF TROPONIN T INCREASE WERE HIGHER NEW YORK HEART ASSOCIATION (NYHA) CLASS (NYHA I VERSUS NYHA IV; P=0.01; NYHA I VERSUS III; P=0.19; NYHA I VERSUS II; P=0.55), CONCOMITANT REVASCULARIZATION (P0.01), PRESENCE OF ELEVATED TROPONIN T BEFORE THE PROCEDURE (P0.01), AND PERIPHERAL OCCLUSIVE DISEASE (P=0.04). AT 30 DAYS, THERE WERE 4 DEATHS (0.5%), 1 STROKE (0.13%), 8 ACUTE MYOCARDIAL INFARCTIONS (1%), AND 5 HOSPITALIZATIONS FOR EXACERBATION OF HEART FAILURE (0.64%).CONCLUSIONS: INTRACORONARY INFUSION OF PROGENITOR CELLS CAN BE PERFORMED WITH ADEQUATE SAFETY IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION OR CHF, BECAUSE THE SAFETY PROFILE WAS SIMILAR TO WHAT IS USUALLY EXPECTED FROM A CORONARY ANGIOGRAM IN THE PRESENT COHORT.CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00962364, NCT00284713, and NCT00289822.
Authors:
Salvatore De Rosa; Florian H Seeger; Jörg Honold; Ulrich Fischer-Rasokat; Ralf Lehmann; Stephan Fichtlscherer; Volker Schächinger; Stefanie Dimmeler; Andreas M Zeiher; Birgit Assmus
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Circulation. Cardiovascular interventions     Volume:  -     ISSN:  1941-7632     ISO Abbreviation:  Circ Cardiovasc Interv     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101499602     Medline TA:  Circ Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Cardiology, Department of Medicine III, Goethe University Frankfurt, Germany.
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