{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:34:13Z","timestamp":1789587253334,"version":"build-2803163510"},"reference-count":33,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2015,6,1]],"date-time":"2015-06-01T00:00:00Z","timestamp":1433116800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cell Transplant"],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:p>\n                    Mononuclear stem cells have been studied for their potential in myocardial ischemia. In our previous published article, ReACT\n                    <jats:sup>\u00ae<\/jats:sup>\n                    phase I\/II clinical trial, our results suggest that a certain cell population, promonocytes, directly correlated with the perceived angiogenesis in refractory angina patients. This study is ReACT's clinical update, assessing long-term sustained efficacy. The ReACT phase IIA\/B noncontrolled, open-label, clinical trial enrolled 14 patients with refractory angina and viable ischemic myocardium, without ventricular dysfunction, who were not suitable for myocardial revascularization. The procedure consisted of direct myocardial injection of a specific mononuclear cell formulation, with a certain percentage of promonocytes, in a single series of multiple injections (24\u201490; 0.2 ml each) into specific areas of the left ventricle. Primary endpoints were Canadian Cardiovascular Society Angina Classification (CCSAC) improvement at the 12-month follow-up and ischemic area reduction (scintigraphic analysis) at the 12-month follow-up, in correlation with ReACT's formulation. A recovery index (for patients with more than 1 year follow-up) was created to evaluate CCSAC over time, until April 2011. Almost all patients presented progressive improvement in CCSAC beginning 3 months ( p = 0.002) postprocedure, which was sustained at the 12-month follow-up ( p = 0.002), as well as objective myocardium ischemic area reduction at 6 months (decrease of 15%, p &lt; 0.024) and 12 months (decrease of 100%, p &lt; 0.004) The recovery index ( n = 10) showed that the patients were graded less than CCSAC 4 for 73.9 \u00b1 24.2% over a median follow-up time of 46.8 months. After characterization, ReACT's promonocyte concentration suggested a positive correlation with CCSAC improvement ( r = \u22120.575, p = 0.082). Quality of life (SF-36 questionnaire) improved significantly in almost all domains. Cost-effectiveness analysis showed decrease in angina-related direct costs. Refractory angina patients presented a sustained long-term improvement in CCSAC and myocardium ischemic areas after the procedure. The long-term follow-up and strong improvement in quality of life reinforce effectiveness. Promonocytes may play a key role in myocardial neoangiogenesis. ReACT dramatically decreased direct costs.\n                  <\/jats:p>","DOI":"10.3727\/096368914x681595","type":"journal-article","created":{"date-parts":[[2014,5,7]],"date-time":"2014-05-07T22:10:20Z","timestamp":1399500620000},"page":"955-970","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Long-Term and Sustained Therapeutic Results of a Specific Promonocyte Cell Formulation in Refractory Angina: ReACT\n                    <sup>\u00ae<\/sup>\n                    (Refractory Angina Cell Therapy) Clinical Update and Cost-Effective Analysis"],"prefix":"10.1177","volume":"24","author":[{"suffix":"Jr.","given":"Americo Hossne","family":"Nelson","sequence":"first","affiliation":[{"name":"Cardiovascular Surgery Division, Surgery Department, Paulista School of Medicine, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Cruz","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"},{"name":"Cellpraxis Bioengeneering, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enio","family":"Buffolo","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Division, Surgery Department, Paulista School of Medicine, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Carolina Teixeira","family":"De Siqueira Mac Dowell Coimbra","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"},{"name":"Cellpraxis Bioengeneering, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaina","family":"Machado","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina Coeli Dos Santos","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Physiology Department, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Germana","family":"Regazzi","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"},{"name":"Cellpraxis Bioengeneering, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Azevedo","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriana Luckow","family":"Invitti","sequence":"additional","affiliation":[{"name":"Cryopraxis Criobiologia Ltda, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"},{"name":"Cellpraxis Bioengeneering, Polo de Biotecnologia do Rio de Janeiro \u2014 Cidade Universit\u00e1ria, Rio de Janeiro, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"Jo\u00e3o Nelson Rodrigues","family":"Branco","sequence":"additional","affiliation":[{"name":"Cardiovascular Surgery Division, Surgery Department, Paulista School of Medicine, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Salvador Rodrigues","family":"De Oliveira","sequence":"additional","affiliation":[{"name":"Hematology Division, Paulista School of Medicine, Federal University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noedir Antonio Groppo","family":"Stolf","sequence":"additional","affiliation":[{"name":"Heart Institute, College of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie W.","family":"Miller","sequence":"additional","affiliation":[{"name":"Cardiology Department, University of South Florida, Tampa, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul R.","family":"Sanberg","sequence":"additional","affiliation":[{"name":"Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA"},{"name":"Office of Research and Innovation, University of South Florida, Tampa, FL, 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