Stem Cell Migratory Activity: Prognostic Marker in Myocardial Ischemia

NCT ID: NCT01271309

Last Updated: 2013-08-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

170 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-07-31

Study Completion Date

2013-07-31

Brief Summary

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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.

Detailed Description

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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

Conditions

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Myocardial Infarction

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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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.

No interventions assigned to this group

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital of Ferrara

OTHER

Sponsor Role collaborator

IRCCS Multimedica

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Marco Valgimigli, MD

Role: PRINCIPAL_INVESTIGATOR

University Ferrara Hospital

Locations

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Cardiology Dept. Arcispedale S.Anna

Ferrara, , Italy

Site Status

IRCCS Multimedica

Milan, , Italy

Site Status

Countries

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Italy

References

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Fortunato O, Spinetti G, Specchia C, Cangiano E, Valgimigli M, Madeddu P. Migratory activity of circulating progenitor cells and serum SDF-1alpha predict adverse events in patients with myocardial infarction. Cardiovasc Res. 2013 Nov 1;100(2):192-200. doi: 10.1093/cvr/cvt153. Epub 2013 Jun 12.

Reference Type RESULT
PMID: 23761401 (View on PubMed)

Other Identifiers

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05/2007_Ferrara

Identifier Type: -

Identifier Source: org_study_id