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March 26, 2013

Scientific Statement of the Philippine Heart Association on Stem Cell Therapy for Heart Disease

• Responding to the growing interest on stem cell therapy (SCT) for heart disease, the Philippine Heart Association recently held an Intercouncil Summit on Stem Cell Therapy in Heart Disease to gather and present objective data on this cell-based therapy in heart disease.

• An extensive review of clinical trials on SCT in patients with acute myocardial infarction (AMI) and left ventricular dysfunction (LVD) was performed. Based on three systematic reviews (most notably involving The Cochrane Library 2012 ) involving 33 randomized controlled trials, bone marrow SCT showed no effect in reducing mortality and morbidity after AMI during short term (six months) and long-term follow ups (1-5 years) over conventional treatment such as angioplasty.

• However, bone marrow SCT improved short-term and long-term left ventricular function (or LV function) and reduced left heart size (LVESV, LVEDV), infarct size and cardiac wall motion. These findings seem very promising. In general, the studies were underpowered to detect changes in clinical outcomes (especially adverse events) since the sample sizes were small. The lack of association with an increase in adverse events is not an assurance of its safety. Thus, larger clinical trials are needed before recommending this intervention for routine clinical use.

• There are no published clinical trials with rigorous methodology which used sheep's stem cell for human use in heart disease.

• Therefore, in the light of all these data, the PHA does not recommend SCT of any kind (from bone marrow, adipose tissues and non-human sources) as a standard of care to reduce cardiovascular risk in patients with heart disease (coronary heart disease and heart failure).

• This conclusion is basically aligned with the pronouncements of the Department of Health that such treatment should be considered "highly investigational for compassionate use".

• PHA supports ethically conducted research studies that will help shed light on some of the uncertainties regarding this modality before it can be recommended as a standard of care in heart disease. This basically acknowledges that more studies with robust designs are needed to further elucidate on the role of SCT as a strategy for heart disease.

(N.B. This statement shall be reviewed periodically when new scientific evidences become available.)

Inter Council Meeting on Stem Cell Therapy
January 25, 2012

Philippine Heart Association Drafts Statement on Stem Cell Therapy

The Philippine Heart Association (PHA) reviewed all the evidences regarding the effects of stem cell therapy (SCT) in patients with heart disease. The data showed that it has no effect in mortality and morbidity and has modest effect on heart functions. Although this is promising, we, the PHA can't recommend its routine use in patients with heart disease.

This was the consensus statement drafted by the PHA during the Inter-Council Meeting on Stem Cell Therapy on Jan. 25, 2013 at the Manila Doctors Hospital, UN Avenue, Manila.

Among the notable speakers were Dr. Eva Maria Cutiongco-Dela Paz, Director of the Institute of Human Genetics, National Institutes of Health, University of the Philippines, and Prof. Rohan Jayasinghe, Director of Cardiology and Cardiac Services, Gold Coast Health Service District, Australia.

Stem cell therapy (SCT) as an intervention strategy for degenerative ailments has created a buzz, globally.
SCT is an intervention approach that introduces new adult stem cells into damaged tissue in order to treat disease or injury. The ability of stem cells to renew and give rise to subsequent generations with valuable degrees of differentiation capacities, offers significant potential for generation of tissues that can potentially replace diseased and damaged areas in the body, with minimal risk of rejection and side effects.

A number of stem cell therapies exists but most are still at experimental stages, with the notable exception of bone marrow transplant. In the Philippines, SCT started to gain popularity and became a familiar term to almost every Juan dela Cruz who is news savvy, following revelations that some celebrities and politicians who have had tried SCT have won the battle against degenerative diseases, including the signs of aging.

Showbiz talent manager Lolit Solit announced on national television last year that she had availed of the very costly stem cell therapy in a foreign country and she claimed that she has been benefiting from its rejuvenating effects. Among the politicians and showbiz denizens who had opted for SCT were former President Joseph Estrada and Lorna Tolentino. Popular hairstylist Ricky Reyes declared that SCT cured his arthritis and he started to feel young at heart.

Despite some testimonials about its being a research marvel by health authorities and patients, there are apprehensions over its safety and efficacy by some health experts, as well as social, religious and political groups who have conflicting views. Amid the proliferation of SCT as a treatment modality done in hospitals and cosmetic surgery centers, the public has been warned about receiving cell preparations offered in the Philippines and elsewhere, such as embryonic, aborted fetus, genetically altered and especially animal stem cells. According to some health experts, the only safe and effectual three sources of stem cells are: the human peripheral blood, human umbilical cords and the human bone marrow.

What are not clear to the public are the true indications of SC and the diseases and conditions to where it is proven effective.

One of the common claims of SCT is its effectiveness on patients with heart disease. And cardiologists all over the country are faced with questions from their patients, whether it is truly effective or not.

For this reason, the Philippine Heart Association has embarked on an intercouncil summit on stem cell therapy dedicated at reviewing the evidences behind the efficacy of stem cell therapy in patients with coronary artery disease and heart failure. Three systematic reviews of SCT in patients with AMI will be presented aside from the intial historical review of SCT. Finally, the PHA will issue its statement on the use of stem cell therapy in patients with heart disease.

Heart Matters

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By Gynna P. Gagelonia

The Philippine Heart Association (PHA) is taking on the challenge of the World Heart Federation (WHF) to work on an ambitious goal: 25 percent reduction in premature cardiovascular disease (CVD) mortality by 2025.

The announcement was made by the PHA Board of Directors who was in full force at the Philippine College of Physicians Health Forum @ Annabel's at T. Morato Ave., Quezon City. The theme was: "Take the Road to a Healthy Heart".



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Preventing Rheumatic Fever & Rheumatic Heart Disease

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