Clinical Trials of Acute Myocardial Infarction (AMI)

Acute Myocardial Infarction or myocardial infarction, or heart attack, is a medical term for a sudden blockage of blood flow in the coronary arteries. Myocardial infarction occurs due to necrosis of the myocardium caused by a lack of oxygen supply to the heart, which cannot be supplied by the coronary arteries. If the blockage is severe, the heart can stop beating. This is characterized by chest pain or discomfort that can radiate to the shoulder, arm, back, neck, or jaw (Khadse) et al.,2020). Various pharmacological agents have been proven to reduce early mortality rates and lower the risk of further heart attacks. However, in cases of extensive infarct areas, alternative treatments for regenerating damaged cells after MI are highly needed.

Cell therapy has emerged as a promising alternative strategy for heart cell regeneration. The rationale for administering cell therapy after acute myocardial infarction (AMI) stems from the assumption that, given the limited regeneration in injured heart tissue, these cells are expected to replace or repair damaged blood vessels and heart tissue (Fisher et al. ., 2015).

Meta-analyses of stem cell therapy for MI and chronic ischemic cardiomyopathy (ICM) using autologous stem cells have shown promising results in terms of improving regional and global LV function, neovascularization, and infarct size (Amado et alUmbilical Cord-Mesenchymal Stem Cells (UC-MSCs) are considered more efficient, easily obtainable, and cultured, with few cells undergoing aging. Several preclinical studies have shown that UCMSCs express specific heart molecules, allowing them to easily differentiate into cardiomyocyte-like cells and endothelial cells in vitro. The paracrine effects provided by UC-MSCs can also enhance blood vessel regeneration and cardiomyocyte protection (Bartolucci et al., 2017). The research was conducted at the National Government General Hospital, Dr. Cipto Mangunkusumo, Faculty of Medicine, University of Indonesia, with an ethical clearance approval number: Ket-302/UN2.F1/ETIK/PPM.00.02/2023

ProSTEM collaborates with dr. Dede Moeswir Sp.PD-KKV, FINASIM, FAPSC, FSCAI To conduct clinical trials to assess the potential of stem cells for treating Acute Myocardial Infarction.

Reference

1. Amado, L. C., Saliaris, A. P., Schuleri, K. H., St. John, M., Xie, J. S., Cattaneo, S., … & Hare, J. M. (2005). Cardiac repair with intramyocardial injection of allogeneic mesenchymal stem cells after myocardial infarction. Proceedings of the National Academy of Sciences, 102(32), 11474-11479.
2. Bartolucci, J., Verdugo, F. J., González, P. L., Larrea, R. E., Abarzua, E., Goset, C., … & Khoury, M. (2017). Safety and efficacy of the intravenous infusion of umbilical cord mesenchymal stem cells in patients with heart failure: a phase 1/2 randomized controlled trial (RIMECARD trial [randomized clinical trial of intravenous infusion umbilical cord mesenchymal stem cells on cardiopathy]). Circulation research, 121(10), 1192-1204.
3. Fisher, S. A., Zhang, H., Doree, C., Mathur, A., & Martin-Rendon, E. (2015). Stem cell treatment for acute myocardial infarction. Cochrane Database of Systematic Reviews, 2015(9). https://doi.org/10.1002/14651858.CD006536.pub4
4. Khadse Neha A., Anjali Mahendra Wankhade, and Ajit G Gaiki. 2020. Myocardial Infraction: Etiology, Risk Factors, Pathophysiology, Diagnosis and Management. Am J Pharma Tech 10(01) 2249-3387 http://dx.doi.org/10.46624/ajptr.2020.v10.i1.014
5. Santoso, T., Irawan, C., Alwi, I., Aziz, A., Kosasih, A., Inggriani, S., … & Lison, L. (2011). Safety and feasibility of combined granulocyte colony stimulating factor and erythropoietin based-stem cell therapy using intracoronary infusion of peripheral blood stem cells in patients with recent anterior myocardial infarction: one-year follow-up of a phase 1 study. Acta Med Indones, 43(2), 112-121.