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Stem Cell Therapy in Refractory Angina Increases Survival and Reduces Costs for Patients

Review of “CD34 + Cell Therapy Significantly Reduces Adverse Cardiac Events, Health Care Expenditures, and Mortality in Patients with Refractory Angina” from STEM CELLS Translational Medicine by Stuart P. Atkinson

A growing number of patients experience refractory angina each year [1]; however, these patients are often ineligible for surgical revascularization [2]. The poor quality of life [3] and high resource use [4] associated with these patients has promoted the search for cost‐efficient alternative therapies. CD34-positive stem cell therapy can promote neovascularization of the myocardium [5], and a recent patient‐level trial meta‐analysis demonstrated significant improvements in exercise time and capacity and a reduction in angina and major adverse cardiac events in patients treated with CD34-positive stem cells compared with placebo [6].

Unfortunately, we know little regarding health care expenditures in refractory angina patients treated with CD34-positive stem cells [7]; therefore, researchers led by Jay H. Traverse (University of Minnesota School of Medicine, Minneapolis, Minnesota, USA) compared the number of cardiac hospital admissions and cardiovascular procedures in the year before treatment against the year after treatment with CD34-positive stem cells or placebo and conducted a cost analysis. Reporting recently in STEM CELLS Translational Medicine, Johnson et al. now report that CD34-positive stem cell therapy improves mortality and reduces both hospital visits and expenditures for cardiac procedures in the year following treatment [8]. 

The authors retrospectively assessed 56 patients at one site in one of three double‐blinded, placebo‐controlled CD34-positive stem cell therapy trials in the 12 months before and after intramyocardial administration of stem cells or placebo. Interestingly, the 37 patients receiving CD34-positive stem cells experienced a significant decrease in cardiac‐related hospital visits (around a 50% reduction), with an associated 62% cost reduction that translates to over 5000 dollars of a saving per patient. Furthermore, those patients receiving CD34-positive stem cells displayed an increase in long-term survival (6.5 ± 2.4 years after enrollment) compared to placebo-treated patients (3.7 ± 1.9 years after enrollment).

Overall, the authors provide evidence that CD34-positive stem cell therapy in refractory angina patients improves long-term survival and reduces both hospital visits and monetary costs in the year after treatment.

For more on the great promise of CD34-positive stem cell therapy, stay tuned to the Stem Cells Portal.


  • Gallone G, Baldetti L, Tzanis G, et al., Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies. JACC: Cardiovascular Interventions 2020;13:1-19.
  • Henry TD, Satran D, and Jolicoeur EM, Treatment of refractory angina in patients not suitable for revascularization. Nature Reviews Cardiology 2014;11:78-95.
  • Andréll P, Ekre O, Grip L, et al., Fatality, morbidity and quality of life in patients with refractory angina pectoris. International Journal of Cardiology 2011;147:377-382.
  • Povsic Thomas J, Broderick S, Anstrom Kevin J, et al., Predictors of Long‐term Clinical Endpoints in Patients With Refractory Angina. Journal of the American Heart Association;4:e001287.
  • Kawamoto A, Iwasaki H, Kusano K, et al., CD34-Positive Cells Exhibit Increased Potency and Safety for Therapeutic Neovascularization After Myocardial Infarction Compared With Total Mononuclear Cells. Circulation 2006;114:2163-2169.
  • Henry TD, Losordo DW, Traverse JH, et al., Autologous CD34+ cell therapy improves exercise capacity, angina frequency and reduces mortality in no-option refractory angina: a patient-level pooled analysis of randomized double-blinded trials. European Heart Journal 2018;39:2208-2216.
  • Nelson AH, Cruz E, Buffolo E, et al., Long-Term and Sustained Therapeutic Results of a Specific Promonocyte Cell Formulation in Refractory Angina: ReACT® (Refractory Angina Cell Therapy) Clinical Update and Cost-Effective Analysis. Cell Transplantation 2015;24:955-970.
  • Johnson GL, Henry TD, Povsic TJ, et al., CD34+ cell therapy significantly reduces adverse cardiac events, health care expenditures, and mortality in patients with refractory angina. STEM CELLS Translational Medicine 2020;9:1147-1152.