Stem cells associated with improved long-term hemodynamics and reduced mortality in chronic heart failure

The largest clinical trial so far of intracoronary autologous stem-cell transplantation in patients with chronic heart failure has shown that such treatment was associated with multiple hemodynamic and functional benefits as well as a reduction in mortality, benefits that were maintained out to five years of follow-up.

The STAR-heart study was presented today at the first clinical-trial hot-line session here at the European Society of Cardiology (ESC) 2010 Congress. However, the same results were published in February this year in the European Journal of Heart Failure, leading some to question their inclusion as a "hot-line" paper. Presenter Dr Bodo-Eckehard Strauer (Heinrich-Heine University, Düsseldorf, Germany) explained that the study was submitted to the journal with the intention of it being published "in parallel" with the ESC presentation, but the journal published it early.

The study involved 391 patients with chronic heart failure following an MI experienced three to eight years previously. Of these patients, 191 accepted the stem-cell treatment while the other 200, who did not agree to the intervention, acted as controls.

The therapy involved taking bone-marrow cells from the iliac crest and isolating mononuclear cells, which were cultivated, harvested, and then re-administered via an intracoronary balloon catheter directly into the infarcted zone. Results at three months, 12 months, and five years after the bone-marrow-cell therapy showed significant improvement in left ventricular ejection fraction, cardiac index, exercise capacity, oxygen uptake, and left ventricular contractility. Controls, however, showed a deterioration in LV performance.



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