intramyocardial injection of autologous bone marrow cells as an adjunctive therapy to incomplete myocardial revascularization: safety issues

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ID: 163435
2008
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Ranked #22 of 128 articles by views in icitacee 2015 - 2nd international conference on information technology, computer, and electrical engineering: green technology strengthening in information technology, electrical and computer engineering implementation, proceedings

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Abstract
OBJECTIVES: To determine the safety of intramyocardial injection of autologous bone marrow cells in patients undergoing surgical myocardial revascularization (CABG) for severe coronary artery disease. INTRODUCTION: There is little data available regarding the safety profile of autologous bone marrow cells injected during surgical myocardial revascularization. Potential risks include arrythmias, fibrosis in the injected sites and growth of non-cardiac tissues. METHODS: Ten patients (eight men) were enrolled; they were 59±5 years old with limiting angina and were non-optimal candidates for complete CABG. Bone marrow cells (1.3±0.3x10(8)) were obtained prior to surgery, and the lymphomonocytic fraction (CD34+=1.8±0.3%) was separated by density gradient centrifugation. During surgery, bone marrow cells were injected in non-grafted areas of ischemic myocardium. During the first year after surgery, the patients underwent laboratory tests, cardiac imaging, and 24-hour ECG monitoring. RESULTS: Injected segments: inferior (n=7), anterior (n=2), septal (n=1), apical (n=1), and lateral (n=1) walls. Except for a transient elevation of C-reactive protein at one month post-surgery (P=0.01), laboratory tests results were within normal ranges; neither complex arrhythmias nor structural abnormalities were detected during follow-up. There was a reduction in functional class of angina from 3.6±0.8 (baseline) to 1.2±0.4 (one year) (P<0.0001). Also, patients had a significant decrease in the ischemic score assessed by magnetic resonance, not only globally from 0.65±0.14 (baseline) to 0.17±0.05 (one year) (P=0.002), but also in the injected areas from 1.11±0.20 (baseline) to 0.34±0.13 (one year) (P=0.0009). CONCLUSIONS: Intramyocardial injection of bone marrow cells combined with CABG appears to be safe. Theoretical concerns with arrhythmias and/or structural abnormalities after cell therapy were not confirmed in this safety trial.
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Authors ;Luís Henrique W. Gowdak;Isolmar T. Schettert;Eduardo Baptista;Nailú L. G. Lopes;Carlos Eduardo Rochitte;Marcelo Luiz C. Vieira;César José Grupi;Luiz Antonio M. César;José Eduardo Krieger;Sérgio A. de Oliveira
Journal icitacee 2015 - 2nd international conference on information technology, computer, and electrical engineering: green technology strengthening in information technology, electrical and computer engineering implementation, proceedings
Year 2008
DOI
10.1590/S1807-59322008000200009
URL
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000200009
Keywords
angiogenesis cardiac surgery cells

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