Stem Cells Derived from Body Fat Improved Certain Cardiac Outcomes

SAN FRANCISCO, CALIF.—Adipose-derived stem and regenerative cells appear to be safe and may lead to improved perfusion and ejection fraction rates as well as lower the incidence of arrhythmia, according to data presented at TCT 2011.

Henricus J. Duckers, MD, PhD, of Erasmus Medical Center, Rotterdam, the Netherlands, reported the latest data from the APOLLO trial, which examined the effects of adipose-derived stem and regenerative cells in patients with STEMI. Duckers explained that the liposuction procedure occurs within 12 hours of primary PCI. In the procedure, the patient gets a small incision and lipoaspiration with a blunt needle; a 20 M cell dose is harvested.

Stem Cells FigureDuckers said their findings showed the adipose-derived stem and regenerative cells improved perfusion by ninefold in the LAD myocardial territory, reduced infarction size by 50%, and the changes persisted at long-term follow up of 18 months (see Figure). Furthermore, Duckers said, their data indicate that these results may be strengthened with higher doses of adipose-derived stem and regenerative cells, as was suggested in a preclinical trial in a pig acute MI model. He cautioned the audience that the cohort only included 14 patients, and that their findings should be “taken with a grain of salt.”

Duckers also noted that his group is conducting the ADVANCE trial, for which, he said, APOLLO laid the groundwork. He said the aim of the ADVANCE study is to demonstrate the efficacy and safety of adipose-derived stem and regenerative cells in patients with acute STEMI. This trial, which has been ongoing since May 2010, includes 375 patients who will be randomized to either placebo, or one of two treatment doses of adipose-derived stem and regenerative cells.

Duckers noted that their data, so far, are consistent with preclinical animal data, with improvements noted in perfusion and paracrine action to reduce myocardial damage.

In another study, SCAMI, presented during the same session, Jochen Wöhrle, MD, of University of Ulm, Germany, noted no improvement in LV ejection fraction or LV volume indices with stem cell therapy (stop flow technique) when compared with placebo at 2 years. Wöhrle said that trial was halted early as a result of the lack of differences.

Wöhrle noted that the study, which looked at 42 patients with acute MI and reperfusion more than 6 hours after symptom onset, showed similar changes between the placebo group and those who received the therapy in terms of LVEF, LV volumes and infarct size after 1, 3, 6, 12 and 24 months.

Wöhrle said his group hypothesizes that the lack of difference may be attributed to the fact that these patients had late perfusion, which may have influenced outcomes. He said it is possible that these patients presented too late for this type of treatment to have an effect.

Disclosures
  • Drs. Duckers and Wohrle report no relevant conflicts of interest.

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