EPC by Intracoronary Injection in Patients With Chronic Stable Angina

Overview

Study title:A Study for Testing Safety and Efficacy of the administration of Blood-Borne Autologous Endothelial Progenitor Cells to Alleviate Anginal Symptoms and Myocardial Ischemia in Patients with Severe Anginal Syndrome Principle Investigator: Assoc. Prof. Damras,Tresukosol,M.D.,Head of Cardiac Catherlization unit,Division of Cardiology,Department of Medicine,Faculty of Medicine Siriraj Hospital,Mahidol University Study objective : To determine the safety and efficacy of intracoronary injection of blood-borne autologous EPCs in relieving symptoms of angina pectoris in symptomatic patients treated with maximal medical therapy with an occluded coronary artery supplying ischemic myocardium Study Design : Phase II, a single center,a non-randomized,open-label trial, Study population : Total expected no. of patients : 24 main selection criteria : * Patients with chronic stable angina on maximal medical therapy and an occluded coronary artery supplying an ischemic viable myocardial region as shown on Sesta-mibi scan. On coronary angiography,the occluded coronary artery must have a patent proximal segment of at least 30 mm with at least one side branch to enable the injection of the EPC if the vessel remains occluded despite the attempted angioplasty efforts. * Age 18-80 years * Ejection fraction \>35 % on Sesta-mibi scan * Sestamibi scan (myocardial perfusion) during exercise or dipyridamole,demonstrating regional reversible ischemia in an area relating to the occluded coronary artery. Investigational Product : At D-8 250 ml of blood drawn from the patients for production of autologous EPCs or ACPs (VescellTM), On D0 ,at least 1.5 million EPCs with viability \>75 % suspended in 6 ml sterile cell culture medium will be injected to the same patients by intracoronary artery. The study consists of 4 periods:Screening ( D-14to-9\&D-8,Treatment(D0),Acute Safety follow-up (D1\&D2),Chronic follow-up (D30,D90\&D180)period ,total follow-up of each case is 6 months. Evaluation criteria : Safety : no.\& duration of adverse event \& serious adverse event Efficacy : * change from baseline to 1,3,6 months of CCS, 6-minute walking test * change from baseline to 3 \& 6 months of Sesta-mibi scan * change from baseline to 3 \& 6 months of symptom-limited exercise time,exercise-induced ischemia \& METs on Sesta-mibi scan Duration of study: July 2004-December 2006