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Stem Cell Migratory Activity: Prognostic Marker in Myocardial Ischemia

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ClinicalTrials.gov Identifier: NCT01271309
Recruitment Status : Completed
First Posted : January 6, 2011
Last Update Posted : August 9, 2013
Sponsor:
Collaborator:
University Hospital of Ferrara
Information provided by (Responsible Party):
IRCCS Multimedica

Brief Summary:
The present project aims to determine whether a deficit in migration of stem cells could be implicated in the failure to mount an adequate collateralization after Myocardial Infarction (MI) and thereby facilitate the development of post-ischemic heart failure (HF) and to dissect underlying molecular mechanisms. Furthermore, the investigators wish to determine the predictive value of stem cell migration assay in patients with MI.

Condition or disease
Myocardial Infarction

Detailed Description:

MAIN OBJECTIVES OF THE STUDY:

Characterization of circulating CD133+ stem cells in a group of 170 patients with MI (mean post-MI follow up, 6 months):

  • Counting total mononuclear cells and FACS analysis of CD133 stem cells.
  • Characterization of CD133+ stem cell biology: Migratory assay, imaging of cytoskeleton, angiogenesis tests in vitro.
  • Evaluation of migratory signalling, with specific focus on the PI3K/Akt/eNOS system.

Assessment of the prognostic value of the stem cell migration assay.

  • Relationship between cell biology tests on CD133+ cells and changes in circulating cytokines and pro-angiogenic factors after MI.
  • Assessment of area at risk by ECG-synchronized Single Photon Emission Computed Tomography (gated-SPECT) in subgroups with different patterns of stem cell migratory tests.
  • Assessment of ventricular remodelling (echocardiography, NMR) in relation with patterns of stem cell migratory test.

EXPECTED RESULTS:

Clarification of the implication of stem cell migratory deficit in post-ischemic HF.

  • Identification of underlying mechanisms
  • Identification of a cellular marker for prediction of patients at risk of HF.

RELEVANCE TO PUBLIC HEALTH:

  • Introduction of a biological test for the early diagnosis of post-MI HF
  • Recognition of therapeutic targets for the rescue of stem cell migratory liabilities

Study Type : Observational
Actual Enrollment : 170 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Migratory and Angiogenic Dysfunction of Circulating CD133 Stem Cells: a New Prognostic Marker in Myocardial Ischemia.
Study Start Date : July 2007
Primary Completion Date : August 2008
Study Completion Date : July 2013

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Attack
U.S. FDA Resources

Group/Cohort
Acute Myocardial Infarction patients
Patients with thoracic pain lasting at least 20 min and ST changes or left B block, not present in previous ECG.



Primary Outcome Measures :
  1. Prognostic value of CD133+ stem cells in MI [ Time Frame: 12 months ]
    Correlation of clinical parameters of disease evolution and biological features


Secondary Outcome Measures :
  1. Correlation of disease evolution and other biomarkers [ Time Frame: 12 months ]


Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Probability Sample
Study Population

Patients will be recruited sequentially at the Operative Unit of Ferrara having the following characteristics: Thoracic pain lasting at least 20 min and ST changes or left B block, not present in previous ECG. MI will be confirmed by elevation of troponin I and CK-MB. Patients will be treated according to international guidelines. With regard to medical treatment, this will include all available drugs except for statins, which will be inserted only 14 days post-MI, to avoid the confounding effect of these drugs on stem cell biology.

Patients reporting thoracic pain 24 hours prior to hospitalization will be excluded. Similarly, those with HF symptoms resistant to therapy will be excluded. By contrast, patients with Killip II e III LV dysfunction will be included.

Criteria

Inclusion Criteria:

  • Age >= 18 years
  • Thoracic pain lasting at least 20 min and ST changes or left B block, not present in previous ECG.
  • MI confirmed by elevation of troponin I and CK-MB.
  • Patients with Killip II e III LV dysfunction will be included.

Exclusion Criteria:

  • Patients reporting thoracic pain 24 hours prior to hospitalization
  • HF symptoms resistant to therapy
  • Haemoglobin< 10 gr/dl
  • Haemodynamic instability (systolic pressure <90 mmHg after treatment)
  • Alterations in haematopoiesys
  • Concurrent neoplastic disease
  • No written informed consent or other conditions that affect patient's compliance to protocol.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01271309


Locations
Italy
Cardiology Dept. Arcispedale S.Anna
Ferrara, Italy
IRCCS Multimedica
Milan, Italy
Sponsors and Collaborators
IRCCS Multimedica
University Hospital of Ferrara
Investigators
Principal Investigator: Marco Valgimigli, MD University Ferrara Hospital

Publications:
Responsible Party: IRCCS Multimedica
ClinicalTrials.gov Identifier: NCT01271309     History of Changes
Other Study ID Numbers: 05/2007_Ferrara
First Posted: January 6, 2011    Key Record Dates
Last Update Posted: August 9, 2013
Last Verified: August 2013

Additional relevant MeSH terms:
Infarction
Myocardial Infarction
Ischemia
Myocardial Ischemia
Coronary Artery Disease
Pathologic Processes
Necrosis
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Coronary Disease
Arteriosclerosis
Arterial Occlusive Diseases