Angiogenic CD34 Stem Cell Therapy in Coronary Microvascular Repair—A Systematic Review
Open Access
- 8 May 2021
- Vol. 10 (5), 1137
- https://doi.org/10.3390/cells10051137
Abstract
Ischemia with non-obstructive coronary arteries (INOCA) is an increasingly recognized disease, with a prevalence of 3 to 4 million individuals, and is associated with a higher risk of morbidity, mortality, and a worse quality of life. Persistent angina in many patients with INOCA is due to coronary microvascular dysfunction (CMD), which can be difficult to diagnose and treat. A coronary flow reserve + cell therapy is a promising treatment option for these patients, as it has been shown to promote vascular repair and enhance angiogenesis in the microvasculature. The resulting restoration of the microcirculation improves myocardial tissue perfusion, resulting in the recovery of coronary microvascular function, as evidenced by an improvement in coronary flow reserve. A pilot study in INOCA patients with endothelial-independent CMD and persistent angina, treated with autologous intracoronary CD34+ stem cells, demonstrated a significant improvement in coronary flow reserve, angina frequency, Canadian Cardiovascular Society class, and quality of life (ESCaPE-CMD, NCT03508609). This work is being further evaluated in the ongoing FREEDOM (NCT04614467) placebo-controlled trial.Funding Information
- National Institutes of Health (K23HL151867)
This publication has 85 references indexed in Scilit:
- In women with symptoms of cardiac ischemia, nonobstructive coronary arteries, and microvascular dysfunction, angiotensin-converting enzyme inhibition is associated with improved microvascular function: A double-blind randomized study from the National Heart, Lung and Blood Institute Women's Ischemia Syndrome Evaluation (WISE)American Heart Journal, 2011
- Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular eventsEuropean Heart Journal, 2011
- Intramyocardial, Autologous CD34+ Cell Therapy for Refractory AnginaCirculation Research, 2011
- Prognostic Value of Global MR Myocardial Perfusion Imaging in Women With Suspected Myocardial Ischemia and No Obstructive Coronary Disease: Results From the NHLBI–Sponsored WISE (Women's Ischemia Syndrome Evaluation) StudyJACC: Cardiovascular Imaging, 2010
- An Intravascular Ultrasound Analysis in Women Experiencing Chest Pain in the Absence of Obstructive Coronary Artery Disease: A Substudy from the National Heart, Lung and Blood Institute–Sponsored Women's Ischemia Syndrome Evaluation (WISE)Journal of Interventional Cardiology, 2010
- Coronary Microvascular Reactivity to Adenosine Predicts Adverse Outcome in Women Evaluated for Suspected Ischemia: Results From the National Heart, Lung and Blood Institute WISE (Women's Ischemia Syndrome Evaluation) StudyJournal of Invasive Cardiology, 2010
- Adverse Cardiovascular Outcomes in Women With Nonobstructive Coronary Artery DiseaseJAMA Internal Medicine, 2009
- Autogenic training to manage symptomology in women with chest pain and normal coronary arteriesMenopause, 2009
- Impact of Ethnicity and Gender Differences on Angiographic Coronary Artery Disease Prevalence and In-Hospital Mortality in the American College of Cardiology–National Cardiovascular Data RegistryJournal of the American College of Cardiology, 2008
- Paradoxical Vasoconstriction Induced by Acetylcholine in Atherosclerotic Coronary ArteriesThe New England Journal of Medicine, 1986