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Pericardial Matrix With Mesenchymal Stem Cells for the Treatment of Patients With Infarcted Myocardial Tissue (PERISCOPE)

Primary Purpose

Myocardial Infarction

Status
Completed
Phase
Phase 1
Locations
Spain
Study Type
Interventional
Intervention
PeriCord: Expanded and cryopreserved allogeneic umbilical cord Wharton´s jelly-derived adult mesenchymal stem cells colonized on human pericardial matrix.
Surgery by sternotomy
Sponsored by
Fundació Institut Germans Trias i Pujol
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Myocardial Infarction focused on measuring Cardiac repair, Wharton jelly mesenchymal stem cells, Chronic myocardial infarction, Tissue engineering, Cell therapy, Clinical trial

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Myocardial infarction of ≥50% of transmurally due to MR
  • Candidate for coronary by-pass through that or another territory
  • Age ≥18 years
  • Signature of informed consent
  • Wave Q present in the ECG
  • Followed by the cardiology service of Germans Trial i Pujol hospital

Exclusion Criteria:

  • Severe valvular disease with indication of surgical repair
  • Candidate for ventricular remodeling
  • Contraindication for MR (creatinine clearance less than 30 ml / min / 1.73m2, metallic implant carriers, claustrophobia)
  • Extracardiac disease with estimated life expectancy less than 1 year
  • Neoplastic disease detected in the last five years or without complete remission
  • Severe renal or hepatic insufficiency
  • Abnormal laboratory values, not explainable at the time of inclusion, and that at the discretion of the investigator contraindicate the patient's participation in the study
  • Patients with a previous cardiac intervention
  • Women who are pregnant or breast-feeding.
  • Women of childbearing age who are heterosexually active and who do not use an effective contraceptive method from 14 days before the inclusion in the study and at least up to 12 weeks after the end of the study.
  • Simultaneous participation in another clinical trial or treatment with another product in investigational phase in the 30 days prior to inclusion in the study.
  • Negation of the patient to be followed by a period that exceeds the clinical trial itself (long-term follow-up in the second and third year).

Sites / Locations

  • Hospital Universitari Germans Trias i Pujol

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Experimental group

Control group

Arm Description

The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. In addition, the matrix-cell (PeriCord) construct will be placed on the ischemic area of the non-candidate revascularization area and will be fixed using surgical glue. PeriCord: Expanded and cryopreserved allogeneic umbilical cord Wharton´s jelly-derived adult mesenchymal stem cells colonized on human pericardial matrix .

The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. No additional procedure will be performed.

Outcomes

Primary Outcome Measures

Rate of death or rehospitalization due to any cause and / or adverse reactions related to the procedure / product under investigation.
Safety measured with a combined endpoint of serious clinical events (death or rehospitalization due to any cause) and serious adverse reactions related to the investigational treatment.

Secondary Outcome Measures

Rate of death or rehospitalization due to any cause and / or adverse reactions related to the procedure / product under investigation.
Safety measured with a combined endpoint of serious clinical events (death or rehospitalization due to any cause) and serious adverse reactions related to the investigational treatment
Death rate or rehospitalization due to cardiovascular causes
Death rate or rehospitalization due to cardiovascular causes at week, 3, 6 and 12 months.
Rate of relevant arrhythmias in Holter of 24 hours
Rate of relevant arrhythmias in Holter of 24 hours a week, 3 and 12 months.
Relevant changes in N-terminal B-type natriuretic peptide (NT-proBNP) and High sensitivity troponin I (hsTnI) levels
Relevant changes in NT-proBNP and hsTnI levels at week, 3 and 12 months.
Changes in the necrotic myocardial mass ratio
Changes in the necrotic myocardial mass ratio due to gadolinium retention at 3 and 12 months.
Changes of regional contractility
change of regional contractility by nuclear magnetic resonance (NMR) at 3 and 12 months.
Changes in ejection fraction of the left ventricle
Changes in ejection fraction of the left at 3 and 12 months
changes in left and right ventricular geometric remodeling
changes in left and right ventricular geometric remodeling at 3 and 12 months
Changes in the score on the quality of life test Short Form 36 Healthy Survey (SF-36).
Changes in the score on the quality of life test SF-36 will be used at 3 and 12 months. The mínimum value is 0 and the máximum value is 100. Higher scores mean a better outcome.
Changes in the score on the quality of life Kansas City Cardiomyopathy Questionnaire (KCCQ) test in cases of participants with heart failure will be used.
Changes in the score on the quality of life test KCCQ in cases of participants with heart failure will be used at 3 and 12 months. The test is composed of 23 items. The options for the answers are Likert scales of 1 to 5, 6 or 7 points and the score of each of its dimensions has a theoretical range from 0 to 100, 100 being the best outcome.

Full Information

First Posted
December 21, 2018
Last Updated
December 1, 2022
Sponsor
Fundació Institut Germans Trias i Pujol
Collaborators
Germans Trias i Pujol Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT03798353
Brief Title
Pericardial Matrix With Mesenchymal Stem Cells for the Treatment of Patients With Infarcted Myocardial Tissue
Acronym
PERISCOPE
Official Title
Pericardial Matrix With Mesenchymal Stem Cells for the Treatment of Patients With Infarcted Myocardial Tissue (The PERISCOPE Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
May 13, 2019 (Actual)
Primary Completion Date
September 27, 2022 (Actual)
Study Completion Date
October 6, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Fundació Institut Germans Trias i Pujol
Collaborators
Germans Trias i Pujol Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Myocardial infarction causes necrosis of myocardial cells and reduces cardiac function. Today, there are treatments such as primary angioplasty and thrombolysis that are effective in limiting cell death after acute myocardial infarction. However, the post-infarct scar often conditions a global ventricular remodeling that can evolve clinically towards heart failure and in more advanced stages the only therapy that completely restores cardiac function is heart transplantation. Mesenchymal stem cells are multipotent cells found from embryonic mesoderm and found in all tissues. In the field of cardiac regeneration, studies have shown a certain degree of benefit when treated with MSCs from different origins. Our approach is based on a decellularized matrix that carries the cells directly over myocardial infarction.
Detailed Description
Myocardial infarction causes necrosis of myocardial cells and reduces cardiac function. Today there are treatments such as primary angioplasty and thrombolysis that are effective in limiting cell death after acute myocardial infarction. However, the post-infarct scar often conditions a global ventricular remodeling that can evolve clinically towards heart failure and, in more advanced stages, the only therapy that completely restores cardiac function is heart transplantation. Experimental studies are evaluating new therapeutic approaches based on tissue engineering for myocardial regeneration. Cardiac tissue engineering attempts to create functional tissue constructs that can restore the structure and function of damaged myocardium. Mesenchymal stem cells (MSCs) are multipotent cells that develop from embryonic mesoderm and are found in all structural tissues of the body. In the field of cardiac regeneration, studies have shown a certain degree of benefit when treated with MSCs from different origins. The investigators approach is based on a decellularized matrix that carries the cells directly over myocardial infarction. Among the different types of MSC currently available, the investigators propose the use of those derived from the connective tissue surrounding the great vessels (2 arteries and one vein) of the umbilical cord called Wharton's gelatin (MSC, WJ) whose immunomodulatory properties are described extensively in the literature. These MSC, WJ cells have a PEI approved by the Spanish Agency for Medicines and Healthcare Products (AEMPS) (PEI 16-017) that guarantees an optimal manufacturing process for a clinical trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Myocardial Infarction
Keywords
Cardiac repair, Wharton jelly mesenchymal stem cells, Chronic myocardial infarction, Tissue engineering, Cell therapy, Clinical trial

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
- Experimental group: The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. In addition, the matrix-cell construct will be placed on the ischemic area of the non-candidate revascularization area and will be fixed using surgical glue. - Control group: The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. No additional procedure will be performed.
Masking
ParticipantInvestigator
Masking Description
The randomization will be known exclusively by the cardiac surgery team and the study coordinator, and it will be blind to the patient and to the rest of the investigators team: clinical cardiologist who performs the follow-up, team that performs image tests, core lab that evaluates the imaging tests and the equipment that statistically analyzes the data.
Allocation
Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Experimental group
Arm Type
Experimental
Arm Description
The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. In addition, the matrix-cell (PeriCord) construct will be placed on the ischemic area of the non-candidate revascularization area and will be fixed using surgical glue. PeriCord: Expanded and cryopreserved allogeneic umbilical cord Wharton´s jelly-derived adult mesenchymal stem cells colonized on human pericardial matrix .
Arm Title
Control group
Arm Type
Active Comparator
Arm Description
The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. No additional procedure will be performed.
Intervention Type
Combination Product
Intervention Name(s)
PeriCord: Expanded and cryopreserved allogeneic umbilical cord Wharton´s jelly-derived adult mesenchymal stem cells colonized on human pericardial matrix.
Intervention Description
A matrix-cell construct (PeriCord) will be placed on the ischemic area of the non-candidate revascularization area during a surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization.
Intervention Type
Procedure
Intervention Name(s)
Surgery by sternotomy
Intervention Description
The patient will undergo surgery by sternotomy to perform the surgical revascularization of the arteries candidates for revascularization. No additional procedure will be performed only the by-pass.
Primary Outcome Measure Information:
Title
Rate of death or rehospitalization due to any cause and / or adverse reactions related to the procedure / product under investigation.
Description
Safety measured with a combined endpoint of serious clinical events (death or rehospitalization due to any cause) and serious adverse reactions related to the investigational treatment.
Time Frame
at 12 months of follow-up
Secondary Outcome Measure Information:
Title
Rate of death or rehospitalization due to any cause and / or adverse reactions related to the procedure / product under investigation.
Description
Safety measured with a combined endpoint of serious clinical events (death or rehospitalization due to any cause) and serious adverse reactions related to the investigational treatment
Time Frame
At 1 week, 3 and 6 months
Title
Death rate or rehospitalization due to cardiovascular causes
Description
Death rate or rehospitalization due to cardiovascular causes at week, 3, 6 and 12 months.
Time Frame
At 1 week, 3 , 6and 12 months
Title
Rate of relevant arrhythmias in Holter of 24 hours
Description
Rate of relevant arrhythmias in Holter of 24 hours a week, 3 and 12 months.
Time Frame
At 1 week, 3 and 12 months
Title
Relevant changes in N-terminal B-type natriuretic peptide (NT-proBNP) and High sensitivity troponin I (hsTnI) levels
Description
Relevant changes in NT-proBNP and hsTnI levels at week, 3 and 12 months.
Time Frame
At 1 week, 3 and 12 months
Title
Changes in the necrotic myocardial mass ratio
Description
Changes in the necrotic myocardial mass ratio due to gadolinium retention at 3 and 12 months.
Time Frame
At 3 and 12 months
Title
Changes of regional contractility
Description
change of regional contractility by nuclear magnetic resonance (NMR) at 3 and 12 months.
Time Frame
At 3 and 12 months
Title
Changes in ejection fraction of the left ventricle
Description
Changes in ejection fraction of the left at 3 and 12 months
Time Frame
At 3 and 12 months
Title
changes in left and right ventricular geometric remodeling
Description
changes in left and right ventricular geometric remodeling at 3 and 12 months
Time Frame
At 3 and 12 months
Title
Changes in the score on the quality of life test Short Form 36 Healthy Survey (SF-36).
Description
Changes in the score on the quality of life test SF-36 will be used at 3 and 12 months. The mínimum value is 0 and the máximum value is 100. Higher scores mean a better outcome.
Time Frame
At 3 and 12 months
Title
Changes in the score on the quality of life Kansas City Cardiomyopathy Questionnaire (KCCQ) test in cases of participants with heart failure will be used.
Description
Changes in the score on the quality of life test KCCQ in cases of participants with heart failure will be used at 3 and 12 months. The test is composed of 23 items. The options for the answers are Likert scales of 1 to 5, 6 or 7 points and the score of each of its dimensions has a theoretical range from 0 to 100, 100 being the best outcome.
Time Frame
At 3 and 12 months
Other Pre-specified Outcome Measures:
Title
monocyte populations and cytokines and chemokines levels
Description
changes in the monocyte populations and cytokines and chemokines levels between the two groups in order to analyze if the PeriCord could improve these variables
Time Frame
At screening, day 3 and day 5

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Myocardial infarction of ≥50% of transmurally due to MR Candidate for coronary by-pass through that or another territory Age ≥18 years Signature of informed consent Wave Q present in the ECG Followed by the cardiology service of Germans Trial i Pujol hospital Exclusion Criteria: Severe valvular disease with indication of surgical repair Candidate for ventricular remodeling Contraindication for MR (creatinine clearance less than 30 ml / min / 1.73m2, metallic implant carriers, claustrophobia) Extracardiac disease with estimated life expectancy less than 1 year Neoplastic disease detected in the last five years or without complete remission Severe renal or hepatic insufficiency Abnormal laboratory values, not explainable at the time of inclusion, and that at the discretion of the investigator contraindicate the patient's participation in the study Patients with a previous cardiac intervention Women who are pregnant or breast-feeding. Women of childbearing age who are heterosexually active and who do not use an effective contraceptive method from 14 days before the inclusion in the study and at least up to 12 weeks after the end of the study. Simultaneous participation in another clinical trial or treatment with another product in investigational phase in the 30 days prior to inclusion in the study. Negation of the patient to be followed by a period that exceeds the clinical trial itself (long-term follow-up in the second and third year).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antoni Bayes-Genís, MD, PhD,FESC
Organizational Affiliation
Institut del Cor, HUGTiP, IGTP
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hospital Universitari Germans Trias i Pujol
City
Badalona
State/Province
Barcelona
ZIP/Postal Code
08916
Country
Spain

12. IPD Sharing Statement

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Pericardial Matrix With Mesenchymal Stem Cells for the Treatment of Patients With Infarcted Myocardial Tissue

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