Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Iran.
Cardiovascular Diseases Research Center, Department of Cardiology, Heshmat Hospital, School of Medicine, Guilan University of Medical Sciences, Iran; Burn and Regenerative Medicine Research Center, Velayat Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Int J Cardiol. 2024 Sep 1;410:132227. doi: 10.1016/j.ijcard.2024.132227. Epub 2024 Jun 4.
Acute ST-elevation myocardial infarction (STEMI) remains a globally significant health challenge in spite of improvement in management strategy. Being aware that mitochondrial dysfunction plays a crucial role in ischaemia-reperfusion injury (IRI) modulation, empirical evidence suggests functional mitochondrial transplantation strikes as a reliable therapeutic approach for patients with acute myocardial infarction.
We conducted a prospective, triple-blinded, parallel-group, blocked randomised clinical trial to investigate the therapeutic effects and clinical outcomes of platelet-derived mitochondrial transplantation in 30 patients with acute STEMI, such that the 15 subjects in the control group were given standard of care treatment, whereas the subjects in the intervention group received autologous platelet-derived mitochondria through the intracoronary injection. We observed that within 40 days, the intervention group had a slightly greater improvement in the left ventricular ejection fraction (LVEF) compared to the control group and experienced a significant enhancement in the exercise capacity (p < 0.001). Moreover, major adverse cardiac events (MACE), arrhythmia, fever, and tachycardia were compared between the groups and lack of significant difference marks the safety of mitochondrial transplantation (p > 0.05). Furthermore, the two groups were not significantly distinct as regards the average length of stay for a hospitalisation (p > 0.05).
We suggest platelet-derived mitochondrial transplantation appears as a beneficial and highly promising therapeutic option for patients of ischaemic heart disease (IHD); however, we are aware that further in-depth studies with larger sample sizes along with longer follow-up periods are necessary for validating the clinical implications of our findings.
尽管急性 ST 段抬高型心肌梗死（STEMI）的管理策略有所改善，但它仍然是全球范围内一个重大的健康挑战。由于意识到线粒体功能障碍在缺血再灌注损伤（IRI）调节中起着至关重要的作用，经验证据表明，功能性线粒体移植作为一种可靠的治疗方法，为急性心肌梗死患者带来了希望。
我们进行了一项前瞻性、三盲、平行组、分组随机临床试验，以研究血小板源性线粒体移植在 30 例急性 STEMI 患者中的治疗效果和临床结局，其中对照组的 15 例患者接受标准治疗，而干预组的患者通过冠状动脉内注射接受自体血小板源性线粒体。我们观察到，在 40 天内，与对照组相比，干预组的左心室射血分数（LVEF）略有改善，运动能力显著增强（p<0.001）。此外，我们比较了两组之间的主要不良心脏事件（MACE）、心律失常、发热和心动过速，没有显著差异表明线粒体移植是安全的（p>0.05）。此外，两组的住院平均时间没有显著差异（p>0.05）。
我们认为，血小板源性线粒体移植似乎是缺血性心脏病（IHD）患者的一种有益且极具前途的治疗选择；然而，我们意识到，需要进行进一步的深入研究，增加样本量并延长随访时间，以验证我们研究结果的临床意义。
