Stem cell therapy for chronic ischaemic heart disease and congestive heart failure

Cardiac stem cells: translation to human studies

“…Over the last decade, attempts to treat patients with various cardiac stem cells from peripheral blood, bone marrow (Fisher et al 2014) and skeletal myoblasts (Menasche et al 2008) have produced varied results with no conclusive evidence of clinically significant regeneration. More recently, encouraging results from clinical trials using human cardiac progenitors such as c-Kit + cells (Bolli et al 2013) and CDCs (Makkar et al 2012;Takehara et al 2012) have emerged.…”

Resultados a largo plazo del trasplante intracoronario de células mononucleares de médula ósea autólogas en pacientes con cardiopatía dilatada de diversa etiología

“…Seguridad de la terapia celular Ninguno de los pacientes sometidos a trasplante intracoronario de CMMO autólogas presentó complicaciones derivadas de este procedimiento a largo plazo, concordando con lo reportado previamente por otros grupos [13][14][15][16][17] . No se encontraron diferencias en la mortalidad o incidencia de otros eventos clínicos mayores entre ambos grupos en el seguimiento a largo plazo.…”

“…Ensayos clínicos randomizados con seguimientos a 5 años, tanto en pacientes con cardiopatía isquémica crónica como miocardiopatía dilatada idiopática, han descrito una disminución de la mortalidad cardiovascular en pacientes sometidos a terapia celular intracoronaria versus pacientes control (p < 0,01) 5,6 . El último meta-análisis de terapia celular en pacientes con cardiopatía isquémica crónica también sugiere una reducción significativa de la mortalidad y la tasa de rehospitalización por insuficiencia cardiaca en pacientes tratados con CMMO en el largo plazo (≥ 12 meses de seguimiento; p < 0,05) 17 . Similar a nuestros resultados, el reporte final del ABCD, ensayo clínico realizado en pacientes con miocardiopatía dilatada idiopática, no describe diferencias en la sobrevida entre pacientes tratados y controles luego de 36 meses de seguimiento 4 .…”

Stem cells for cardiac repair—should we be cautious?

“…[3][4][5][6] Only a small number of participants have been enrolled into most studies, but some meta-analyses have, nevertheless, been performed to evaluate the benefit of BMSC therapy for cardiac repair. [7][8][9] For example, in one meta-analysis the investigators included 50 studies (a total of 2,625 patients), and reported that BMSCs improved left ventricular ejection fraction (LVEF), reduced infarct size, and limited remodelling in patients with ischaemic heart disease (IHD), and that these benefits seemed to persist during long-term follow-up. 8 Similarly, the authors of a 2014 Cochrane Systematic Review, which included 23 randomized controlled trials involving 1,255 participants, reported that BMSC treatment can improve LVEF, mortality, and performance status in the long term (after at least 1 year) in individuals with IHD and heart failure.…”

“…8 Similarly, the authors of a 2014 Cochrane Systematic Review, which included 23 randomized controlled trials involving 1,255 participants, reported that BMSC treatment can improve LVEF, mortality, and performance status in the long term (after at least 1 year) in individuals with IHD and heart failure. 9 Meta-analyses are considered the highest level of evidence and might have a major effect on future health policy decisions; therefore, ensuring their accuracy is of paramount importance. Although these studies were not discussed in the Review by Behfar et al 1 many clinical researchers interested in this field will refer to these meta-analyses and feel optimistic about the results.…”