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Cell Therapy in Patients With Chronic Ischemic Heart Disease Undergoing Cardiac Surgery

Information source: Chinese PLA General Hospital
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Old Myocardial Infarction; Chronic Myocardial Ischemia; Left Ventricular Dysfunction

Intervention: bone marrow mononuclear cells injection (Procedure); placebo intramyocardial injection (Procedure)

Phase: Phase 1/Phase 2

Status: Recruiting

Sponsored by: Chinese PLA General Hospital

Official(s) and/or principal investigator(s):
Gao Changqing, MD, Study Chair, Affiliation: Chinese PLA General Hospital

Overall contact:
Changqing Gao, MD, Phone: +8601066938035, Email: gaochq301@yahoo.com

Summary

This prospective, randomized, placebo-controlled study was designed to assess the safety, feasibility and efficacy of intramyocardial injection of autologous bone marrow mononuclear cells in patients with severe, chronic ischemic disease scheduled to coronary artery bypass surgery.

Clinical Details

Official title: A Prospective,Randomized, Placebo-Controlled Study of Intramyocardial Injection of Autologous Bone-Marrow Mononuclear Cells in Patients With Severe, Chronic Ischemic Heart Disease Undergoing Coronary Bypass Surgery

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver), Primary Purpose: Treatment

Primary outcome: major adverse cardiac events

Secondary outcome: left ventricular function

Detailed description: Severe ischemic heart disease remains a clinical challenge; many patients have undergone surgical myocardial revascularization procedures, but still remain symptomatic despite optimal medical therapy. Cell therapy with autologous bone marrow-derived cells (BMC) is a novel therapeutic strategy being tested for surgical treatment in patients with severe, chronic ischemic heart disease. This research study is being performed to find out more information about the safety, feasibility, and efficacy of direct intramyocardial injection of autologous BMC on the myocardial perfusion and left ventricular function as an adjunctive therapy (compared to placebo) in patients undergoing coronary artery bypass surgery (CABG). The heart function evaluations will be performed by electrocardiogram, echocardiogram, and cMRI at baseline and during 6 months follow-up. The secondary objective of this study is to assess the effect of intramyocardial injection of autologous BMC on functional class (angina/heart failure), global and cardiovascular mortality, and major adverse cardiac events after undergoing coronary artery bypass surgery.

Eligibility

Minimum age: 18 Years. Maximum age: 75 Years. Gender(s): Both.

Criteria:

Inclusion Criteria: 1. Age between 18 and 75 years. 2. Scheduled to undergo CABG. 3. At least 3 months since last episode of myocardial infarction. 4. Echocardiogram-assessed LVEF between 15 and 40% (Simpson's rule). 5. Abnormal wall motion of at least one segment due to prior myocardial infarction shown by echocardiography or left ventriculography. 6. Abnormal myocardial perfusion in infarcted area by SPECT. 7. Willingness to participate and ability to provide written informed consent. Exclusion Criteria: 1. Contraindications to magnetic resonance imaging. 2. Need for urgent or emergent revascularization. 3. Severe valvular heart disease. 4. Confirmed myocardial infarction within 14 days, and/or rising cardiac biomarker proteins (i. e. troponin), and/or worsening ECG changes. 5. Prior cardiac surgery. 6. Stroke within 3 months prior to CABG. 7. Immunosuppressive medication (e. g. prednisone, cyclophosphamide, etanercept, etc.) 8. Severe chronic renal insufficiency (serum creatinine ≥ 200 mmol/dl or need for dialysis), liver disease, (diagnosis of cirrhosis, chronic hepatitis, or elevation of serum transaminases ≥3 times the upper limit of normal), cerebrovascular disease requiring concomitant carotid endarterectomy, peripheral arterial disease (claudication as the primary factor limiting activity), active non-dermatological malignancy requiring on-going treatment, or any other condition that would place the patient at increased risk for complications in the judgment of the attending cardiologist or cardiac surgeon 9. Hemoglobin less than 10g/dL, white blood cell count less than 4,000/mm3, absolute neutrophil count less than 1500/mm3 10. Active infection, with a temperature greater than 37. 5°C within 48 hrs prior to surgery and an unexplained white blood cell count in excess of 10,000/mm3 11. Significant cognitive impairment. 12. Any condition associated with a life expectancy of less than 6 months. 13. Participation in other studies. 14. Positive laboratory test results for HIV, HBC, and HCV. 15. Pregnant woman. 16. Inability or unwillingness to provide written informed consent.

Locations and Contacts

Changqing Gao, MD, Phone: +8601066938035, Email: gaochq301@yahoo.com

Chinese PLA General Hospital, Beijing, Beijing 100853, China; Recruiting
Wang Rong, MD, Principal Investigator
Zhang Lin, MD, Principal Investigator
Additional Information

Starting date: December 2010
Last updated: January 11, 2011

Page last updated: August 23, 2015

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