Therapeutic neovascularization for ischemic heart disease.
The demonstration that angiogenic growth factors stimulate new blood vessel growth and restore perfusion in animal models of myocardial and peripheral vascular ischemia has prompted the translation of therapeutic angiogenesis from bench to bedside. The enthusiasm generated from early, open-label, safety trials using primarily vascular endothelial growth factors or fibroblast growth factor protein or gene therapy has been tempered by double-blind randomized placebo controlled studies that have yielded variable though potentially promising results. This article reviews the basis of angiogenic therapy, lessons learned from the latest major trials and potential refinements for future therapy.
Division of Cardiothoracic Surgery, St Michael's Hospital, and University of Toronto, Toronto, Ontario.
Michael
M
Lekas
Michael J B
MJ
Kutryk
David A
DA
Latter
Duncan J
DJ
Stewart
D017322:Clinical Trials, Phase II as Topic; D004311:Double-Blind Method; D005260:Female; D005346:Fibroblast Growth Factors / Q000627:therapeutic use*; D005500:Follow-Up Studies; D015316:Genetic Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000628:therapy*; D018919:Neovascularization, Physiologic / Q000187:drug effects*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012016:Reference Values; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000627:therapeutic use*
D011994:Recombinant Proteins; D042461:Vascular Endothelial Growth Factor A; D005346:Fibroblast Growth Factors