Abstract
This phase II randomized controlled trial tested whether intracoronary autologous CD34+ cell therapy could further improve left ventricular (LV) systolic function in patients with diffuse coronary artery disease (CAD) with relatively preserved LV ejection fraction (defined as LVEF >40%) unsuitable for coronary intervention. Between December 2013 and November 2017, 60 consecutive patients were randomly allocated into group 1 (CD34+ cells, 3.0 × 107/vessel/n = 30) and group 2 (optimal medical therapy; n = 30). All patients were followed for one year, and preclinical and clinical parameters were compared between two groups. Three-dimensional echocardiography demonstrated no significant difference in LVEF between groups 1 and 2 (54.9% vs. 51.0%, respectively, p = 0.295) at 12 months. However, compared with baseline, 12-month LVEF was significantly increased in group 1 (p < 0.001) but not in group 2 (p = 0.297). From baseline, there were gradual increases in LVEF in group 1 compared to those in group 2 at 1-month, 3-months, 6-months and 12 months (+1.6%, +2.2%, +2.9% and +4.6% in the group 1 vs. −1.6%, −1.5%, −1.4% and −0.9% in the group 2; all p < 0.05). Additionally, one-year angiogenesis (2.8 ± 0.9 vs. 1.3 ± 1.1), angina (0.4 ± 0.8 vs. 1.8 ± 0.9) and HF (0.7 ± 0.8 vs. 1.8 ± 0.6) scores were significantly improved in group 1 compared to those in group 2 (all p < 0.001). In conclusion, autologous CD34+ cell therapy gradually and effectively improved LV systolic function in patients with diffuse CAD and preserved LVEF who were non-candidates for coronary intervention (Trial registration: ISRCTN26002902 on the website of ISRCTN registry).
Highlights
Despite state-of-the-art management strategies for coronary artery disease (CAD) including pharmacomodulation [1,2], continuous education [3], guideline renewal [4], instrument refinement [4,5,6,7], refined technique in percutaneous coronary intervention (PCI) [8,9,10] and the matured operative procedure of coronary artery bypass surgery (CABG) [3,11], it remains the leading cause of death in the last decade
Within subgroup analysis, we found no data regarding the therapeutic benefits of endothelial progenitor cells (EPCs) for patients with diffuse CAD and preserved left ventricular (LV) ejection fraction (LVEF) who were unsuitable for coronary intervention despite their associated symptoms of angina and dyspnea
This laid the foundation for the current study that investigated whether IC administration of autologous CD34+ cells would improve cardiac function and symptoms of heart failure (HF) and angina in patients with diffuse CAD and relatively preserved LV systolic function unsuitable for coronary intervention
Summary
Despite state-of-the-art management strategies for coronary artery disease (CAD) including pharmacomodulation [1,2], continuous education [3], guideline renewal [4], instrument refinement [4,5,6,7], refined technique in percutaneous coronary intervention (PCI) [8,9,10] and the matured operative procedure of coronary artery bypass surgery (CABG) [3,11], it remains the leading cause of death in the last decade. Within subgroup analysis, we found no data regarding the therapeutic benefits of endothelial progenitor cells (EPCs) for patients with diffuse CAD and preserved LV ejection fraction (LVEF) who were unsuitable for coronary intervention despite their associated symptoms of angina and dyspnea. This laid the foundation for the current study that investigated whether IC administration of autologous CD34+ cells would improve cardiac function and symptoms of HF and angina in patients with diffuse CAD and relatively preserved LV systolic function unsuitable for coronary intervention
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
