Combination Stem Cell (MESENDO) Therapy for Utilization and Rescue of Infarcted Myocardium

NCT00548613 | Completed Phase 1

• 1 other identifier: 2007-02-I
• Study Type: interventional
• Target: 20
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this research study is to determine if the transplant of a combination of stem cells, obtained from the bone marrow of the same patient, is effective for utilization and rescue of infarcted myocardium. End points will be the assessment of development of mature and stable new blood vessels as well as improvement in cardiac function. This, Phase I, single center, prospective, non-randomized, open-label study will evaluate the safety and feasibility of use of the proposed combination of autologous stem cells. Potential subjects who fulfill clinical and laboratory entry criteria at screening will undergo a process of bone marrow aspiration for preparation of the two types of bone marrow-derived stem /progenitor cells to use. The two bone marrow-derived cell types will be mixed and implanted to patients approximately 2 weeks after bone marrow aspiration. After transplant, patients will be have a 3 month follow-up to evaluate safety as well as functional heart improvement by analysis of symptoms, myocardial perfusion SPECT, and echocardiography. Study population will include adult male and female subjects, ages 18-70, presenting with acute myocardial infarction and subjects who have had a recent (within 12 months) myocardial infarction and will undergo coronary artery bypass grafting. Patients will be divided in two groups:

• the first group will enroll patients with acute myocardial infarction whom percutaneous coronary intervention restored myocardial flow after 4 hours or greater of the initiation of symptoms,
• the second group will enroll patients who are candidates for coronary artery bypass surgery and had a myocardial infarction in the past 12 months. Patients will receive the cell mixture by intracoronary or intramyocardial infusion, respectively. The rationale of this clinical study is based on the observation that most attempts using adult stem cells for myocardial regeneration have utilized a source of bone marrow derived progenitor cells with the potential to generate new blood vessel and thus contribute to the revascularization of the ischemic tissue. This therapy seems to be adequate but not sufficient, since it lacks a source of stem cells capable of differentiating and maturing into cardiac muscle cells, thus contributing to the recovery of local contractility. The proposed combination stem/progenitor cell therapy to be used in this protocol is aimed at contributing cell types capable of regenerating both blood vessels and muscle tissues damaged after MI.

Conditions

Coronary Artery Disease; Coronary Arteriosclerosis; Coronary Atherosclerosis; Coronary Disease

Keywords

Myocardial Infarction; Heart Attack; Coronary Artery Bypass Grafting

Outcome Measures

Primary Outcomes (1)

• Safety

  6 months

Study Arms (2)

A

EXPERIMENTAL

Patients with documented acute myocardial infarction (heart attack) occurring within 4-24 hours after onset of symptoms

Biological: MESENDO

B

EXPERIMENTAL

Candidates for coronary artery bypass grafting that suffered a myocardial infarction (heart attack) within the past 12 months

Biological: MESENDO

Interventions

MESENDO BIOLOGICAL

Intracoronary transplantation of autologous stem cells via balloon catheter

A

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• ARM: A -
• Patients with acute myocardial infarction with ST elevation who underwent percutaneous revascularization between 4 and 24 hours after the initiation of symptoms.
• Able to give written informed consent
• Age: 18 to 70 years
• Gender: Male and Female
• Acute myocardial infarction occurring within 4-24 hours after onset of symptoms documented by at least one of the following:
• ST Segment elevation greater than 2mm in two or more consecutive leads
• New Bundle Branch Block with symptoms consistent of MI
• Troponin I greater than 2.0 ng/ml (Normal Range 0 - 1.5 ng/ml)
• Totally occluded artery as visualized by angiography
• ARM - B
• Patients who are candidates for coronary artery bypass grafting surgery according to ACC/AHA guidelines and have had a myocardial infarction in the past 12 months.
• Able to give written informed consent
• Patients with coronary artery disease who need coronary artery bypass surgery according to ACC/AHA guidelines
• Patients with Left Ventricular Ejection Fraction £ 40%.

You may not qualify if:

• ARM - A
• Pregnancy
• Previous angiogenic therapy or myocardial laser therapy
• History of cancer within 5 years
• Known sensitivity to gentamycin and/or amphotericin B
• Use or expected use of antineoplastic drugs
• No informed consent or unable to provide informed consent.
• Any illness which, in the Investigator's judgment, will interfere with the patient's ability to comply with the protocol, compromise patient's safety, or interfere with the interpretation of the study results.
• Any illness which might affect patient's survival over the study follow-up period
• History of skeletal muscle disease, either primary (i.e., myopathy) or secondary (i.e., ischemic) or any underlying myopathy such as myasthenia gravis, muscular dystrophy, etc.
• Patients with active infectious disease and/or who are known to have tested positive for HIV, HTLV, HBV-sAg, HCV, CMV and/or syphilis
• Cardiogenic shock or severe compromise in left ventricular systolic function defined as ejection fraction lower than 20 %.
• History of intolerance to amiodarone.
• End stage renal disease
• Contraindication for MRI

Sponsors & Collaborators

• TCA Cellular Therapy: lead

Study Sites (1)

TCA Cellular Therapy, LLC

Covington, Louisiana, 70433, United States

Location

MeSH Terms

Conditions

Coronary Artery Disease; Coronary Disease; Myocardial Infarction

Condition Hierarchy (Ancestors)

Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Vascular Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Study Officials

• Gabriel P. Lasala, M.D.

  TCA Cellular Therapy, LLC

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 1
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: SINGLE GROUP
• Sponsor Type: INDUSTRY

Study Record Dates

• First Submitted: October 22, 2007
• First Posted: October 24, 2007
• Study Start: October 1, 2007
• Primary Completion: December 1, 2008
• Study Completion: March 1, 2009
• Last Updated: April 28, 2011

Record last verified: 2011-04

Locations

US (1)