Intracoronary Stem Cell Therapy in Patients With Acute Myocardial Infarction (SCAMI)

NCT00669227 — Phase 2, Completed, 42 participants, University of Ulm

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Intracoronary Stem Cell Therapy in Patients With Acute Myocardial Infarction - A Randomized, Double-blind, Placebo Controlled Trial (SCAMI)

RegistryNCT00669227, acronym SCAMI
StatusCompleted
PhasePhase 2
Study typeInterventional; randomized, parallel, masking: quadruple, treatment
Enrollment42 (Actual)
SponsorUniversity of Ulm (Other)
ConditionsAcute Myocardial Infarction, Coronary Artery Disease
Interventionsautologous stem cells, placebo suspension (Other)
Datesstart 2005-10-01, primary completion 2009-01-01, first posted 2008-04-30, last updated 2014-06-10
Locations1 site in Germany

Related Papers Related Patents Related Grants Related Experts
All trials for Acute Myocardial Infarction All trials for Coronary Artery Disease All trials of autologous stem cells All trials of placebo suspension

-Summary

Autologous stem cells may improve myocardial regeneration after intracoronary administration in patients with acute myocardial infarction. The primary hypothesis of this prospective, placebo-controlled, double-blind trial is that the increase of ejection fraction determined by magnetic resonance imaging between baseline and 6 months follow-up is superior in active treated patients compared to patients receiving placebo. The study includes an integrated pilot phase of 40 patients for evaluation of left ventricular ejection fraction determined by cardiac magnetic resonance imaging. Based on the data of this analysis the final sample size will be calculated. The primary endpoint is the improvement in left ventricular ejection fraction with an assumed 2.5% higher improvement in the cell treated population compared to the placebo treated group.

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+Detailed description

There is a 2:1 randomization for bone marrow cell therapy versus placebo therapy. Patients will be stratified according to age, localization of myocardial infarction and left ventricular function.

+Arms and interventions

ArmTypeInterventionsDescription
1Active comparatorOther: autologous stem cellsautologous stem cells, Ficoll preparation, intracoronary administration at the same day of bone marrow cell aspiration
2Placebo comparatorOther: placebo suspensionplacebo is visually indistinguishable from verum due to integration of autologous erythrocytes, intracoronary administration the same day of bone marrow aspiration
  • autologous stem cells (Other): intracoronary administration at the same day of cell aspiration using the stop flow technique
  • placebo suspension (Other): intracoronary administration at the same day as cell aspiration

+Outcome measures

Primary outcomes

  • difference in left ventricular ejection fraction measured by magnetic resonance imaging at baseline and 6 months follow-up [6 months]

Secondary outcomes

  • left ventricular ejection fraction measured by magnetic resonance imaging [1, 3, 12 months]
  • left ventricular enddiastolic volume measured by magnetic resonance imaging [1, 3, 6, 12 months]
  • left ventricular endsystolic volume measured by magnetic resonance imaging [1, 3, 6, 12 months]
  • major adverse cardiac events [1, 3, 6, 12 months]

+Eligibility

Sex: All, ages: 35 Years to 75 Years

Inclusion Criteria:

* acute myocardial infarction with time to revascularization >6 hours from symptom start
* clear target vessel
* large myocardial infarction defined as: proximal vessel occlusion, CK > 1000 U/L, myocardial scar in magnetic resonance imaging > 10% of left ventricular muscle mass
* potential prior thrombolysis
* written informed consent

Exclusion Criteria:

* acute myocardial infarction with revascularization within 6 hours after symptom start
* prior myocardial infarction
* no clear target vessel
* contraindication for magnetic resonance imaging (e.g. pacemaker, ICD)
* severely depressed left ventricular ejection fraction (less than 20% in magnetic resonance imaging)
* prior hematologic disease
* prior chemo therapy
* prior stem cell transplantation
* prior treatment with G-CSF
* known alteration of the bone marrow by alcohol or drugs, e.g. agranulocytosis
* local infection of puncture sites

+Locations (1)

FacilityCityCountryStatus
University of UlmUlmGermany

+Publications

  • Wohrle J, Merkle N, Mailander V, Nusser T, Schauwecker P, von Scheidt F, Schwarz K, Bommer M, Wiesneth M, Schrezenmeier H, Hombach V. Results of intracoronary stem cell therapy after acute myocardial infarction. Am J Cardiol. 2010 Mar 15;105(6):804-12. doi: 10.1016/j.amjcard.2009.10.060. PMID 20211323
  • Wohrle J, von Scheidt F, Schauwecker P, Wiesneth M, Markovic S, Schrezenmeier H, Hombach V, Rottbauer W, Bernhardt P. Impact of cell number and microvascular obstruction in patients with bone-marrow derived cell therapy: final results from the randomized, double-blind, placebo controlled intracoronary Stem Cell therapy in patients with Acute Myocardial Infarction (SCAMI) trial. Clin Res Cardiol. 2013 Oct;102(10):765-70. doi: 10.1007/s00392-013-0595-9. Epub 2013 Jul 30. PMID 23896972

+Investigators

  • Jochen Wöhrle, MD; FESC, Principal investigator, University of Ulm