Navegando por Palavras-chave "Refractory angina"

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    Terapia celular na angina refratária (ReACT) envolvendo células tronco autólogas de medula óssea em pacientes sem disfunção ventricular esquerda: um possível papel dos monócitos
    (Universidade Federal de São Paulo (UNIFESP), 2010-01-27) Hossne Junior, Nelson Americo [UNIFESP]; Buffolo, Enio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background Autologous bone marrow mononuclear cell (BMMC) transplantation has emerged as a potential therapeutic option for refractory angina patients. Previous studies have shown conflicting myocardium reperfusion results. The present study evaluated safety and efficacy of CellPraxis Refractory Angina Cell Therapy Protocol (ReACT™), in which a specific BMMC formulation was administered as the sole therapy for these patients. Methods The Phase I/IIa Non-controlled, Open label, Clinical Trial, involved eight patients with refractory angina and viable ischemic myocardium, without left ventricular dysfunction and who were not suitable for conventional myocardial revascularization. ReACT™ is a surgical procedure involving a single series of multiple injections (40-90 injections, 0.2 ml each) into ischemic areas of the left ventricle. Primary endpoints were Canadian Cardiovascular Society Angina Classification (CCSAC) improvement at the 18 month follow-up and myocardium ischemic area reduction (assessed by scintigraphic analysis) at the 12 month followup, in correlation with a specific BMMC formulation. Findings Almost all patients presented progressive improvement in angina classification beginning 3 months (p=0.008) post procedure which was sustained at the eighteenth month follow-up (p=0.004), as well as objective myocardium ischemic area reduction at 12 months (decrease of 84.4%, p<0.004). A positive correlation was found between monocyte concentration and CCSAC improvement (r = -0.759, p < 0.05). Interpretation Improvement in Canadian Cardiovascular Society Angina Classification, followed by correlated reduction in scintigraphic myocardium ischemic area strongly suggests neoangiogenesis as the main stem cell action mechanism. The significant correlation between number of monocytes and improvement strongly supports a cell related effect of ReACT™. ReACT™ appeared safe and effective.