Treatment of Refractory Angina with Peripheral Blood-derived Stem Cell Using the Transendocardial Injection Route

REVIEW, February 2011, VOL I ISSUE III, ISSN 2042-4884
10.5083/ejcm.20424884.27 , Cite or Link Using DOI
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Juan Jose González Ferrer, Pilar Jiménez-Quevedo, Maria del Trigo

ABSTRACT

Despite the development of new anti-ischemic drugs and the improvements in revascularisation techniques, a substantial proportion of patients with ischemic heart disease remain symptomatic with severe debilitating angina. The major aim of therapy for these patients should be aggressive modification of risk factors and optimising medical and interventional treatment. Nevertheless, when disease progresses and standard treatments are not possible, new strategies should be established. In this setting, treatment with peripheral blood-derived stem cells using the transendocardial injection is a new promising option.


INTRODUCTION

Refractory angina constitutes a serious clinical problem. The European Society of Cardiology has defined refractory angina as a chronic condition (> 3 months) characterised by the presence of angina caused by coronary insufficiency due to coronary artery disease which can not be controlled by a combination of medical therapy, angioplasty and coronary bypass surgery.

The prevalence of refractory angina is growing due to the improvement in the survival of patients with coronary heart disease. Patients with no options may account for up to 12% of those referred for diagnostic catheterisation. Reason for ineligibility include: the presence of diffuse coronary disease, disease in small distal vessels, recurrent in stent restenosis, chronic total occlusion and multivessel disease in patients with important co-morbidities.