{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:17:58Z","timestamp":1792513078904,"version":"4.5.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND:<\/jats:title>\n            <jats:p>XC001 is a novel adenoviral-5 vector designed to express multiple isoforms of VEGF (vascular endothelial growth factor) and more safely and potently induce angiogenesis. The EXACT trial (Epicardial Delivery of XC001 Gene Therapy for Refractory Angina Coronary Treatment) assessed the safety and preliminary efficacy of XC001 in patients with no option refractory angina.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS:<\/jats:title>\n            <jats:p>\n              In this single-arm, multicenter, open-label trial, 32 patients with no option refractory angina received a single treatment of XC001 (1\u00d710\n              <jats:sup>11<\/jats:sup>\n              viral particles) via transepicardial delivery.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS:<\/jats:title>\n            <jats:p>There were no severe adverse events attributed to the study drug. Twenty expected severe adverse events in 13 patients were related to the surgical procedure. Total exercise duration increased from a mean\u00b1SD of 359.9\u00b1105.55 seconds at baseline to 448.2\u00b1168.45 (3 months), 449.2\u00b1175.9 (6 months), and 477.6\u00b1174.7 (12 months; +88.3 [95% CI, 37.1\u2013139.5], +84.5 [95% CI, 34.1\u2013134.9], and +115.5 [95% CI, 59.1\u2013171.9]). Total myocardial perfusion deficit on positron emission tomography imaging decreased by 10.2% (95% CI, \u22123.1% to 23.5%), 14.3% (95% CI, 2.8%\u201325.7%), and 10.2% (95% CI, \u22120.8% to \u221221.2%). Angina frequency decreased from a mean\u00b1SD 12.2\u00b112.5 episodes to 5.2\u00b17.2 (3 months), 5.1\u00b17.8 (6 months), and 2.7\u00b14.8 (12 months), with an average decrease of 7.7 (95% CI, 4.1\u201311.3), 6.6 (95% CI, 3.5\u20139.7), and 8.8 (4.6\u201313.0) episodes at 3, 6, and 12 months. Angina class improved in 81% of participants at 6 months.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSIONS:<\/jats:title>\n            <jats:p>XC001 administered via transepicardial delivery is safe and generally well tolerated. Exploratory improvements in total exercise duration, ischemic burden, and subjective measures support a biologic effect sustained to 12 months, warranting further investigation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>REGISTRATION:<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT04125732.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.124.014054","type":"journal-article","created":{"date-parts":[[2024,5,2]],"date-time":"2024-05-02T16:31:06Z","timestamp":1714667466000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Angiogenic Gene Therapy for Refractory Angina: Results of the EXACT Phase 2 Trial"],"prefix":"10.1161","volume":"17","clinical-trial-number":[{"clinical-trial-number":"nct04125732","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9209-597X","authenticated-orcid":true,"given":"Kenta","family":"Nakamura","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine (K.N.), University of Washington, Seattle."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1123-0533","authenticated-orcid":true,"given":"Timothy D.","family":"Henry","sequence":"additional","affiliation":[{"name":"The Carl and Edith Lindner Center of Research and Education, The Christ Hospital, Cincinnati, OH (T.D.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2108-0252","authenticated-orcid":true,"given":"Jay H.","family":"Traverse","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute Foundation, Abbott Northwestern Hospital, MN (J.H.T., B.C.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Latter","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, St. Michael\u2019s Hospital, University of Toronto, ON, Canada (D.A.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7189-5997","authenticated-orcid":true,"given":"Nahush A.","family":"Mokadam","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Ohio State University Wexner Medical Center, Columbus (N.A.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey A.","family":"Answini","sequence":"additional","affiliation":[{"name":"The Christ Hospital, Cincinnati, OH (G.A.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam R.","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular and Thoracic Surgery, 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