Myocardial Infarction

Stem cell therapy for Myocardial Infarction

Myocardial infarction, commonly known as a heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia. This usually results from an imbalance in oxygen supply and demand, which is most often caused by plaque rupture with thrombus formation in a coronary vessel, resulting in an acute reduction of blood supply to a portion of the myocardium or muscles death. The risk factors for atherosclerosis and heart attack include elevated cholesterol levels, increased blood pressure, tobacco use, diabetes, male gender, and a family history of heart attacks at an early age.

Types of Myocardial Infarction (MI) : –

MI is of five types follows as : –
Type 1 – Type 1 is a spontaneous MI related to ischemia from a primary coronary event (e.g., plaque rupture, thrombotic occlusion)
Type 2 – Myocardial infarction secondary to ischaemia due to either increased oxygen demand or decreased supply, e.g. coronary artery spasm, coronary embolism, anaemia, arrhythmias, hypertension, or hypotension
Type 3 – Sudden unexpected cardiac death, including cardiac arrest.
Type 4 – Associated with coronary angioplasty or stents:
1) Type 4a – Myocardial infarction associated with PCI
2) Type 4b – Myocardial infarction associated with stent thrombosis as documented by angiography or at autopsy
Type 5 – Myocardial infarction associated with CABG .

STEM CELL SERVICES FOR Myocardial Infarction : –

Currently available surgical or endovascular revascularization like angioplasty and coronary artery bypass graft (CABG) and drug based method are available treatment for Myocardial Infarction and coronary arterial disease.

But the stem cells transplant with angioplasty and CABG induces neo-myogenesis and neo-vascularization. Because neo-myogenesis or muscle regeneration is very difficult task in heart attack patient by its self even after angioplasty and CABG.

In case of angioplasty, stem cell transplantation performs into the infarct-related coronary artery and induces both new blood formation and muscle regeneration and also decrease the further chance of heart attack.But in case of bypass surgery (or CABG), stem cell transplantation perform into the transplanted artery and directly into the infracted myocardium and induce new muscles regeneration and also decrease the further chance of heart attack.

Protocol Outline for Myocardial Infarction:-

We transplant “Bone marrow-derived stem cells concentrate (BMSCs)” via intrathecally/intravenously because it provides a rich growth factor (VEGF, TGF-ß, FGF) environment that may enhance the neuron formation. The iliac crest contains bone marrow which is a rich source of the regenerative cells including:-

Mesenchymal Stem Cells (MSCs, CD44+)):- MSCs which differentiate into many types of cells such as bone, cartilage, neuron and so more.
Hematopoietic Stem Cells (HSCs, CD34+)):- HSCs which differentiate into all types of blood cells and also provide enhance environment for MSCs activation.
Endothelial Stem Cells (ESCs, CD31+)):- ESCs which differentiate into all types of blood vessels.
Platelets: –
1) To modulate the regeneration process
2) Recruit bone marrow progenitor cells to loci of injury
3) Provides adhesion site for stem cells
4) Platelets fibrin provides migration highway at the site of injury
We also infuse cultured mesenchymal stem cells isolated from bone marrow/cord tissue because MSCs is the multipotent cell which is able to differentiate into damaged muscle cells in case of myocardial infarction.
We also start stem cell supplement (Stem-Kine) during and after stem cell transplantation to get better improvement.

Follow-up with patients:-

Our medical staff members will be in contact with patients to get complete follow-up at 1, 3, 6 months and I year interval.

Scientific Articles:-

1. Strauer et al. 2010 (European Journal of Heart Failure). The acute and long-term effects of intracoronary Stem cell Transplantation in 191 patients with chronic heary failure: the STAR-heart study.

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