Safety and Efficacy of Intracoronary Human Umbilical Cord-Derived Mesenchymal Stem Cell Treatment for Very Old Patients with Coronary Chronic Total Occlusion

Abstract

This study aimed to investigate the safety and feasibility of intracoronary injection of human umbilical cord mesenchymal stem cell to the very old patients with coronary chronic total occlusion. 15 consecutive patients received mesenchymal stem cells from human umbilical cord in epicardial coronary artery supplying collateral circulation. The patients were randomly allocated to low-dose 3x10(6), mid-dose 4x10(6) and high-dose 5x10(6) groups. (99m)Tc single photon emission computed tomography images were obtained at 12 and 24 months. During the 24 month study period, no cases of major cardiac adverse events were reported. None of the patients had coronary care unit admissions hospitalizations further coronary revascularization acute myocardial infarction and death. The patients had a significant reduction of the infarct size and a remarkable rise in left ventricular ejection fraction with respect to secondary outcomes. This study suggested that stem cell transplantation was safe and feasible. The cells can be utilized to improve in the degree of ischemic myocardium, decrease in the infarct size and rise in left ventricular ejection fraction.

Oxidative stress and inflammation: Early predictive indicators of multiple recurrent coronary in‐stent chronic total occlusions in elderly patients after coronary stenting

“…The coronary angiograms were analyzed by two blinded coronary interventionalists and one geriatric expert. According to the guidelines of the American Society of Echocardiography, the Doppler color echocardiography images were analyzed with the synchronized surface electrocardiograms by the two blinded cardiologists and one geriatric expert …”

Unbalanced Oxidant‐Antioxidant Status: A Potential Therapeutic Target for Coronary Chronic Total Occlusion in Very Old Patients

“…Discrepancies were resolved by consensus of a third cardiologist. According to the American Society of Echocardiography Standards, a complete Doppler echocardiography study was carried out with electrocardiograms synchronized by two independent cardiologists who were blinded to the clinical trial data of all subjects as described [31]. …”

“…Our findings suggested that intracoronary infusion of human umbilical cord mesenchymal stem cells ameliorated left ventricular ejection fraction and decreased infarct size remarkably in very old patients with coronary CTO [31, 32]. However, primary percutaneous coronary intervention procedures took longer and had the risks of radiation skin injury and acute kidney injury.…”

Stem cells; mesenchymal stem cells and current clinical applications

“…[48] 2015 yılında yaptıkları bir çalımada; 15 hastaya rastgele göbek kordonundan elde edilmi MKH'leri nakletmiler ve hastaların enfarktüs alanlarında belirgin bir azalma saptarken, sol ventrikülde-ki ejeksiyon fraksiyonunun belirgin bir ekilde arttı¤ını gözlemlemilerdir. [48] Nörolojik hastalıklarda, MKH'ler özellikle omurilik yaralanmaları, MS, Parkinson ve amiyotrofik lateral skleroz (ALS) gibi hastalıkların tedavisinde ilgi çekici olmutur. Mezenkimal kök hücreler bu hastalıkların tedavisinde kullanılmakta olup, uzun dönem sonuçları beklenmektedir.…”