CD34+ Cell Therapy Significantly Reduces Adverse Cardiac Events, Health Care Expenditures, and Mortality in Patients with Refractory Angina.,STEM CELLS Translational Medicine

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CD34+ Cell Therapy Significantly Reduces Adverse Cardiac Events, Health Care Expenditures, and Mortality in Patients with Refractory Angina.
STEM CELLS Translational Medicine ( IF 5.4 ) Pub Date : 2020-06-12 , DOI: 10.1002/sctm.20-0046
Grace L Johnson ₁ , Timothy D Henry _{1,

2} , Thomas J Povsic ₃ , Douglas W Losordo ₄ , Ross F Garberich ₁ , Larissa I Stanberry ₁ , Craig E Strauss ₁ , Jay H Traverse _{1,

5}

Affiliation

Patients with refractory angina who are suboptimal candidates for further revascularization have improved exercise time, decreased angina frequency, and reduced major adverse cardiac events with intramyocardial delivery of CD34⁺ cells. However, the effect of CD34⁺ cell therapy on health care expenditures before and after treatment is unknown. We determined the effect of CD34⁺ cell therapy on cardiac‐related hospital visits and costs during the 12 months following stem cell injection compared with the 12 months prior to injection. Cardiac‐related hospital admissions and procedures were retrospectively tabulated for patients enrolled at one site in one of three double‐blinded, placebo‐controlled CD34⁺ trials in the 12 months before and after intramyocardial injections of CD34⁺ cells vs placebo. Fifty‐six patients were randomized to CD34⁺ cell therapy (n = 37) vs placebo (n = 19). Patients randomized to cell therapy experienced 1.57 ± 1.39 cardiac‐related hospital visits 12 months before injection, compared with 0.78 ± 1.90 hospital visits 12 months after injection, which was associated with a 62% cost reduction translating to an average savings of $5500 per cell therapy patient. Patients in the placebo group also demonstrated a reduction in cardiac‐related hospital events and costs, although to a lesser degree than the CD34⁺ group. Through 1 January 2019, 24% of CD34⁺ subjects died at an average of 6.5 ± 2.4 years after enrollment, whereas 47% of placebo patients died at an average of 3.7 ± 1.9 years after enrollment. In conclusion, CD34⁺ cell therapy for subjects with refractory angina is associated with improved mortality and a reduction in hospital visits and expenditures for cardiac procedures in the year following treatment.

中文翻译：

CD34+ 细胞疗法可显着降低难治性心绞痛患者的不良心脏事件、医疗保健支出和死亡率。

不适合进行进一步血运重建的难治性心绞痛患者的运动时间得到改善，心绞痛频率降低，并通过心肌内递送 CD34 ⁺细胞减少了主要的不良心脏事件。然而，CD34 ⁺细胞疗法对治疗前后医疗保健支出的影响尚不清楚。我们确定了在干细胞注射后 12 个月内与注射前 12 个月相比，CD34 ⁺细胞疗法对心脏相关医院就诊和费用的影响。在三个双盲、安慰剂对照 CD34 ⁺在心肌内注射 CD34 ⁺细胞与安慰剂前后 12 个月的试验。56 名患者随机接受 CD34 ⁺细胞治疗（n = 37）与安慰剂（n = 19）。随机接受细胞治疗的患者在注射前 12 个月经历了 1.57 ± 1.39 次心脏相关医院就诊，而注射后 12 个月则为 0.78 ± 1.90 次医院就诊，这与成本降低 62% 相关，即每次细胞治疗平均节省 5500 美元病人。安慰剂组的患者也表现出心脏相关医院事件和费用的减少，但程度低于 CD34 ⁺组。到 2019 年 1 月 1 日，CD34 ^{+ 的}24%受试者在入组后平均 6.5 ± 2.4 年死亡，而 47% 的安慰剂患者在入组后平均 3.7 ± 1.9 年死亡。总之，对于难治性心绞痛患者的CD34 ⁺细胞疗法与死亡率的提高以及治疗后一年内就诊次数和心脏手术费用的减少有关。

更新日期：2020-06-12

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