Myocardial infarction (MI) is the irreversible death of heart muscle secondary to prolonged lack of oxygen supply. A heart attack, or myocardial infarction, is permanent impairment to the heart muscle. “Myo” refers to muscle, “cardial” means to the heart, and “infarction” means death of tissue due to absence of blood supply. Generally, a heart attack takes place due to lack of oxygen supply to the heart or blockage of oxygen supply. The blockage is most often a build-up of fat, cholesterol, which leads to the formation of plaque in the arteries that feed or nourish the heart. The plague eventually breaks away and forms a clot. The interrupted blood flow through the arteries can damage part of the heart muscle. A heart attack, also known as myocardial infarction, can be fatal, but treatment has developed intensely over the years. Globally, cardiovascular disease (CD) is a public health problem comprising 30 percent of worldwide mortality and 10 percent of the global disease burden. In 2020 , from a total of 75 million deaths globally, 17 million were due to CD and, among them, 7.6 million occurred due to coronary heart disease. MI is one of the 5th main manifestations of coronary heart disease, specifically stable angina pectoris, unstable angina pectoris, MI, heart failure and sudden death.
Treatment for myocardial infarction
Restoring blood circulation rapidly helps inhibit heart damage.
Medication
* Aspirin
* Thrombolytics
* Antiplatelet agents
* Other blood-thinning medications
* Pain relievers
* Nitroglycerin
* Beta blockers
* ACE inhibitors
* Statins
Surgical procedures
* Coronary angioplasty and stenting
* Coronary artery bypass surgery
Usage of stem cells on Myocardial Infarction
Stem cell transplantation is considered a promising method to treat Myocardial Infarction (MI), which has made momentous development in preclinical and clinical studies. These stem cell candidates are divided into two categories: pluripotent stem cells such as embryonic stem cells and induced pluripotent stem cells and their derivatives, and adult stem cells, comprising hematopoietic stem cells and mesenchymal stem cells (MSCs).
MSCs are mesoderm-derived multipotent stromal cells that exist in embryonic and adult tissues. They possess the potential ability for self-renewal, immunomodulation, immune privilege, and low tumorigenicity. Up to now, MSCs have been considered the most practiced cell type in clinical trials for treating MI, due to their safety, nutritional activity, multi-differentiation potential, and immunomodulatory properties. MSCs possess low immunogenicity because of low expression of MHC II as well as the lack of expression of MHC I, which results in immune tolerance permitting allogeneic transplantation.
Several studies have demonstrated the effectiveness of both autologous and allogeneic MSCs for the treatment of acute MI. In a phase I randomized study conducted by Hare et al., 53 patients were randomized to receive either allogeneic MSCs or placebo seven to ten days after MI and in several doses. In this study, intravenous infusion of allogeneic MSCs resulted in improvement in overall clinical status six months after treatment, improved ejection fraction, and fewer arrhythmic events.
The significant and positive outcome of this pilot study led to a phase II trial involving intravenous infusion of allogeneic MSCs within seven days of an acute MI. This resulted in significantly reduced cardiac hypertrophy, arrhythmia, heart failure, stress-induced ventricular events, and rehospitalizations for cardiac problems. On the other hand, Chen et al. administered autologous MSCs intracoronary in patients with subacute MI and reported improved left ventricular ejection fraction, decreased perfusion defect, and left ventricular remodeling three months after stem cell therapy.
In conclusion, while more clinical trials are needed to establish stem cell therapy in India as a significant therapeutic tool for the treatment of Myocardial Infarction, the current research shows promising results. For MedTravellers seeking cutting-edge treatments, stem cell therapy for MI represents an exciting frontier in regenerative medicine. As this field continues to evolve, it may offer new hope and improved outcomes for patients suffering from heart-related conditions. MedTravellers should stay informed about the latest developments in stem cell research and consider consulting with specialists in countries at the forefront of these innovative therapies.
