Stem cell therapy for myocardial infarction | Overview including symptoms and causes

Myocardial infarction is a serious heart disease in which a coronary artery that nourishes the heart becomes completely blocked, resulting in myocardial tissue necrosis due to lack of oxygen. It is associated with intense chest pain and pressure. If left untreated, it poses a high risk of fatality, thus necessitating prompt treatment when an attack occurs. Generally, revascularization is performed through a catheter or bypass surgery.

In recent years, stem cell therapy has attracted attention as a method for repairing damaged myocardium at the cellular level, and there are high expectations for this regenerative medicine technique in the context of myocardial infarction.
In this article, we organize the symptoms and causes of myocardial infarction and explain why stem cell therapy could accomplish fundamental improvements in patients with this disease.

What is myocardial infarction?

Myocardial infarction is a disease in which a coronary artery is completely blocked by a thrombus or atherosclerosis, stopping blood flow to the myocardial tissue and depriving it of oxygen and nutrients. If the blockage persists for a long time, the cardiac muscle will be irreversibly damaged (resulting in necrosis), and the pumping function of the heart will be significantly reduced.
Unlike angina pectoris, myocardial infarction is characterized by persistent intense chest pain and pressure, and the pain does not improve even after rest. If appropriate treatment is not provided upon onset, the majority of the cardiac muscle will be necrotized, and the risk of cardiac failure or fatal arrhythmia increases. *1

*1 Reference: NewHeart Watanabe Institute

Symptoms of myocardial infarction

In myocardial infarction, the following symptoms often occur suddenly.

• Severe chest pain: Persistent squeezing pain in the chest slightly to the left or the center of the chest. Pain may radiate to the left arm, back, and mandible.
• Cold sweat and facial pallor: Shock reactions due to pain cause cold sweat and facial pallor.
• Dyspnea or shortness of breath: Patients feel suffocated as the pumping function of the heart deteriorates, resulting in insufficient blood supply to the whole body.
• Arrhythmia and disturbed consciousness: Patients may fall into a half-conscious state in serious cases due to a disturbance in the heart’s electrical rhythm.

If pain persists for more than 30 minutes and does not improve after rest, it is recommended to request emergency medical services immediately. *2

*2 Reference: Sendai Kousei Hospital

Causes of myocardial infarction

The major cause of myocardial infarction is coronary artery stenosis due to atherosclerosis, where a plaque rupture leads to blood clot formation, resulting in the complete blockage of the blood vessel. The following risk factors can lead to the progression of atherosclerosis:

• Hypertension: The force of blood pushing against the walls of blood vessels is high, making the endothelium susceptible to injury.
• Dyslipidemia: Increased LDL cholesterol levels promote plaque formation.
• Diabetes mellitus: Hyperglycemia damages the vascular endothelium, thus accelerating atherosclerosis.
• Smoking: Nicotine and carbon monoxide cause vasoconstriction, which increases the risk of atherosclerosis.
• Obesity and lack of exercise: Excessive calorie intake and decreased basal metabolism adversely affect lipid metabolism.

In addition, coronary spastic angina (i.e., spasms in the coronary arteries) can cause myocardial infarction in some cases. Thus, detailed examination is necessary if patients complain of chest pain.

Reference: Japanese Association of Cardiovascular Intervention and Therapeutics

Stem cell therapy as a promising radical treatment for myocardial infarction

The use of stem cells is attracting attention as a treatment for myocardial infarction.

Here, we will explain the background of stem cells as a topic of research interest and the advantages of using them.

What is stem cell therapy?

Currently, the mainstay of treatment for myocardial infarction involves the following approach: catheter surgery or coronary artery bypass surgery is performed in the acute phase to recanalize the blood vessel, followed by drug therapy to prevent recurrence. Stem cell therapy, a regenerative medicine technique that aims to repair necrotic or damaged tissues, has drawn attention due to its potential ability to support the regeneration of cardiac cells and blood vessels. Stem cells have the ability to both self-renew and undergo multilineage differentiation, and they are expected to support myocardial regeneration in a multifaceted manner via the secretion of growth factors that suppress inflammation and induction of angiogenesis.

Advantages of stem cell therapy

The following advantages are the reason for the recent interest in stem cell therapy in the context of myocardial infarction.

• Regeneration of cardiomyocytes: Stem cells differentiate into cardiomyocytes and replace/supplement damaged areas; hence, it is possible to attain cardiac function recovery.
• Angiogenesis: Stem cells secrete cytokines that are involved in angiogenesis and inflammatory suppression and promote the improvement of blood flow in the surrounding tissue.
• Fewer side effects: When autologous stem cells are used, there are low risks of rejection and significant adverse reactions.
• Reduced recurrence risk: It may fundamentally supplement cardiac function and prevent recurrence in the future.

Reasons why stem cell therapy is effective

Stem cells have multifaceted actions, including the secretion of growth factors that suppress inflammation and promote vascular regeneration. After myocardial infarction, it is usually difficult to produce new cardiomyocytes in necrotic myocardial tissue as they simply become fibrotic (scarring); however, improving the cell proliferation environment using stem cells has been suggested to potentially improve or maintain the pumping function of the heart for a long period of time. However, since the degree of efficacy changes depending on the disease severity, constitution of the patient, time from onset, and other factors, it is important to determine the appropriate indication.

Flow of treatment at the Regenerative Medicine Division of Korokai Medical Corporation

At the Regenerative Medicine Division of Korokai Medical Corporation, the following steps are taken when administering stem cell therapy for myocardial infarction.

1. Initial counseling and tests: We will perform echocardiography, MRI, blood test, and other tests to obtain a detailed understanding of cardiac function and the extent of infarction. The indication for stem cell therapy is comprehensively determined upon confirming the patient’s medical history and concomitant diseases.
2. Stem cell collection and culture: Stem cells will be harvested from adipose tissue and cultured in a clean room while controlling quality and safety.
3. Preparation of the treatment plan: We will formulate an individual treatment plan while considering the amount and frequency of stem cell administration and combination with other treatments (e.g., drug therapy, rehabilitation).
4. Administration of stem cells and follow-up: After stem cells are introduced to the heart or blood vessels by drip infusion, we will perform cardiac function tests and blood tests on a regular basis, possibly in cooperation with doctors at other hospitals. Additional dose administration may be considered, if necessary.

Possibility of stem cells as a treatment method for myocardial infarction

Myocardial infarction is a dangerous disease that causes acute attacks due to occlusion of the coronary artery, leading to necrosis of the cardiac muscle. Stem cell therapy aims to achieve radical recovery after myocardial infarction as a regenerative medicine technique with the potential to support the regeneration of the cardiac muscle and blood vessels and suppress inflammation. The Regenerative Medicine Division of Korokai Medical Corporation proposes a stem cell therapy plan according to individual conditions and provides support aimed at maintaining or improving the function of the heart.

The Regenerative Medicine Division of Korokai Medical Corporation offers stem cell-based regenerative medicine as a medical institution approved by the Ministry of Health, Labour and Welfare. *4

If you are interested in stem cell therapy, please contact our hospital for consultation.
The Regenerative Medicine Division of Korokai Medical Corporation carefully selects evidence-based treatment and offers regenerative medicine according to each individual’s concerns based on novel comprehensive treatment strategies. To optimize the results, oral therapies such as bioidentical hormone replacement therapy or peptide therapy can be combined with stem cell therapy, if preferred.

*4 Source:Ministry of Health, Labour and Welfare

The Regenerative Medicine Division of Korokai Medical Corporation – a stem cell therapy clinic in Tokyo

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[1] Therapeutic Method
The treatment involves harvesting and culturing stem cells from the patient’s adipose tissue and then injecting them locally to the affected area or administering them via intravenous infusion.
[2] Risk of side effects
At the time of fat collection: Adverse reactions such as internal bleeding, swelling, postoperative infection, postoperative scar, and pain at the injection site may be observed.
At the time of stem cell administration: Adverse reactions such as pain at the injection site, allergic reaction, and pulmonary embolism may be observed.
[3] Contact information
The Regenerative Medicine Division, Korokai Medical Corporation
5th floor, Precious 18, 4-14-6 Minami-Azabu, Minato-ku, Tokyo
TEL:03-6277-4650
[4] Pricing
This treatment is a private therapeutic strategy that is not covered by public health insurance.
For culture of approximately 100–180 million stem cells
*Depending on the number of stem cell cultures obtained from each individual, it may be less than 100 million stem cells.
1 cycle costs 2.5 million yen (tax included)
3 cycles cost 7.2 million yen (payment in installments: 2.5 million yen for the first and second cycles, 2.3 million yen for the third cycle)
5 cycles cost 11.5 million yen (tax included) (payment in installments: 2.5 million yen for the first through fourth cycles, 1.5 million yen for the fifth cycle)
For culture of approximately 200–280 million stem cells
*Depending on the number of stem cell cultures obtained from each individual, it may be less than 200 million stem cells.
1 cycle costs 3.8 million yen (tax included)
3 cycles cost 11.1 million yen (tax included) (payment in installments: 3.8 million yen for the first and second cycles, 3.5 million yen for the third cycle)
5 cycles cost 17.5 million yen (tax included) (payment in installments: 3.8 million yen for the first through fourth cycles, 2.3 million yen for the fifth cycle)
Please consult us for further details.
[5] Route of acquisition
Stem cells are cultured at the affiliated CPC.
[6] Presence or absence of devices/drugs approved for the indications in Japan
No approved drugs for the indications are available in Japan.
[7] Safety information from other countries
There are no reports on safety in other countries.
*Significant risks may not have been identified.
[8] The fact that it has not been approved
Drugs used in this treatment are yet to receive approval in accordance with the Pharmaceutical and Medical Device Act.
[9] Unapproved drugs/devices
Public aid systems (such as Relief Systems for Adverse Drug Reactions and Infections Acquired through Biological Products) are not applicable to unapproved drugs and devices.
[10] Notification of regenerative medicine provision plans
To perform this treatment, we have submitted the notification of regenerative medicine provision plans to the Ministry of Health, Labour and Welfare in accordance with the Act on the Safety of Regenerative Medicine.
Ministry of Health, Labour and Welfare, Class II Regenerative Medicine Provision Plan No. PB3210146
Ministry of Health, Labour and Welfare, Class II Regenerative Medicine Provision Plan, No. PB3230187
Ministry of Health, Labour and Welfare, Class II Regenerative Medicine Provision Plan, No. PB3240017
Ministry of Health, Labour and Welfare, Class II Regenerative Medicine Provision Plan, No. PB3230218
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