Rapid Delivery of Autologous Bone Marrow Derived Stem Cells in Acute Myocardial Infarction Patients. (AMIRST)

September 3, 2013 updated by: TotipotentRX Cell Therapy Pvt. Ltd.

Intracoronary Infusion of Concentrated Autologous Bone Marrow Mononuclear Cells in Acute Myocardial Infarction Patients Utilizing a Novel Point-of-Care Device for Rapid-Delivery of Stem Cells (AMIRST)

The primary objective of the study is to determine the feasibility and safety of intracoronary administration of autologous bone marrow derived mononuclear cell product in patients at risk for clinically significant cardiac dysfunction following AMI.

The secondary objective of the study is to assess the effect on cardiac function and infarct region perfusion. A concurrent placebo control patient group meeting eligibility but not receiving autologous bone marrow derived stem cells will be evaluated similar to the treated group to assess the rate of significant spontaneous improvement in cardiac function.

Study Overview

Status

Unknown

Conditions

Intervention / Treatment

Detailed Description

Emerging evidence indicate that progenitor stem cells derived from bone marrow can be used to improve cardiac function in acute myocardial infarction patients. There is a great potential for stem cell therapy, using a variety of cell precursors to contribute to new blood vessel formation and muscle preservation in the myocardial infarct zone. The administration of cells via an infusion through the infarct related artery appears to be feasible and result in a clinical effect in some studies. Across the globe AMI is the leading cause of morbidity and mortality. This cannot be prevented by optimal standard therapies i.e. balloon or stent dilation of the infarct vessels.

The study is a double blind, placebo controlled, randomized, multicenter trial. Male or female patients between 18-75 years with first incidence of Acute Myocardial Infarction(AMI) and LVEF less than or equal to 40% are included in the study. Patients who have undergone successful percutaneous intervention (PCI) within ≤ 24 hours after onset of symptoms (PTCA/stent) or / and Thrombolysed patients having TIMI-3 flow are eligible to take part in the study.

A total of 30 subjects will be recruited and randomly assigned to receive concentrated BMMNC or placebo. All patients will undergo bone marrow aspiration within 3-10 days from the index event(infarction). Bone Marrow(BM) will be processed utilizing point of care technology. Following cell processing, the concentrated BMMNC or placebo control is infused directly into the infarct related artery using the stop flow method. Clinical follow up for all the subjects at 1,30, 60, 90, 180 and 360 days will be performed from the day of the procedure, with primary and secondary end points evaluated for both study arms.

Study Type

Interventional

Enrollment (Anticipated)

30

Phase

  • Phase 2
  • Phase 1

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • India
      • Hyderabad, India, 500034
        • CARE Hospitals, Banjara Hills
      • New Delhi, India, 110025
        • Fortis Escorts Heart Institute and Research Centre
      • New Delhi, India, 110070
        • Fortis Flt. Lt. Rajan Dhall Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Male or Female of age 18 - 75 years
  • Incidence of first myocardial infarction
  • Acute STEMI with LV hypokinesia involving anteroseptal, lateral or inferior walls
  • LVEF < 40% pre-intervention
  • Successful percutaneous intervention (PCI) within ≤ 24 hours after onset of symptoms (PTCA/stent) or / and Thrombolysed patients having TIMI-3 flow.
  • Written informed consent

Exclusion Criteria:

  • Multi-vessel coronary disease requiring surgical intervention (CABG) or left main coronary artery disease > 50% blockage
  • Previous history of CABG
  • Pulmonary edema
  • Cardiogenic shock
  • Myocarditis
  • Renal or hepatic dysfunction
  • Hematologic disease

General Exclusion Criteria:

  • Alcohol or drug dependency, active or uncontrolled acute myocarditis
  • HIV, HBV, or HCV infections
  • Evidence of malignant or hematological diseases
  • Metal implants of any kind
  • Claustrophobia
  • Renal insufficiency
  • History of bleeding disorder
  • Anemia (haemoglobin <8.5mg/dl)
  • Platelet count <100,000/ml

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Quadruple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Treatment
Implantation of bone marrow derived mononuclear cells
Other: Autologous Bone marrow mononuclear cells
Intracoronary administration of concentrated BMMNC on the same day of BM aspiration using point of care technology.
Other Names:
  • BMMNC treatment group
Placebo Comparator: Placebo Control
Infusion of autologous peripheral blood
Other: Placebo control
Intracoronary infusion of autologous peripheral blood.
Other Names:
  • Placebo control group

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of adverse events as a measure of safety
Time Frame: 12 Months
Feasibility and safety of Intracoronary infusion of autologous BMMNCs processed through intraoperative point of care technology, freedom from arrhythmia's.
12 Months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Changes in the global Left Ventricular Ejection Fraction(LVEF), LV volumes-End Systolic Volume (ESV) and End Diastolic Volume (EDV), infarct size, myocardial mass, myocardial viability and regional wall motion abnormalities.
Time Frame: 12 Months
Changes in the global Left Ventricular Ejection Fraction(LVEF), LV volumes-End Systolic Volume (ESV) and End Diastolic Volume (EDV), infarct size, myocardial mass, myocardial viability and regional wall motion abnormalities measured by Cardiac MRI and assessed by central Core lab.
12 Months
Major adverse cardiac events (MACE)
Time Frame: 12 Months
MACE was defined as the composites of any cause of death, myocardial infarction, revascularization of the target vessel, re-hospitalization for heart failure, and life-threatening arrhythmia.
12 Months
Quality of life
Time Frame: 12 Months
Quality of life assessment is done using short-form 36, Minnesota living with heart failure questionnaire and Seattle Angina Questionnaire
12 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

TotipotentRX Cell Therapy Pvt. Ltd.

Collaborators

TotipotentRX Corporation

Investigators

  • Study Director: Venkatesh Ponemone, PhD, TotipotentRX Cell Therapy Pvt. Ltd.
  • Study Chair: Kenneth Harris, MS, TotipotentRX Cell Therapy Pvt. Ltd.
  • Principal Investigator: Ashok Seth, FRCP, FACC, Fortis Escorts Heart Institute and Research Centre
  • Principal Investigator: Upendra Kaul, MD,DM, FACC, Fortis Flt. Lt. Rajan Dhall Hospital
  • Principal Investigator: Sreenivas A Kumar, MD, DM, FACC, CARE Hospitals, Hyderabad, India

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2013

Primary Completion (Anticipated)

January 1, 2015

Study Completion (Anticipated)

March 1, 2015

Study Registration Dates

First Submitted

July 16, 2011

First Submitted That Met QC Criteria

February 17, 2012

First Posted (Estimate)

February 20, 2012

Study Record Updates

Last Update Posted (Estimate)

September 4, 2013

Last Update Submitted That Met QC Criteria

September 3, 2013

Last Verified

September 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • TPRX/POC/BMSC/AMIRST/1.0

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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