Refractory Angina Pectoris: Focus on Cell Therapy

Although medical and surgical treatments often provide adequate solutions for individuals with coronary artery disease, an increasing need exists to develop treatment modalities for those patients with angina who are unresponsive to medical therapy, have serious coronary atherosclerosis, and are not eligible for percutaneous techniques or bypass surgery, a condition known as refractory angina pectoris. In recent years, alternative experimental therapeutic options (e.g. ranolazine, enhanced external counter-pulsation, shock waves) have been proposed in order to alleviate symptoms and improve the quality of life in these patients. A promising therapeutic option arising from basic research is the use of autologous cells directly inoculated into the ischemic heart. Preliminary clinical trial results are encouraging. Aim of this chapter is to review the current knowledge on refractory angina, focusing on cell therapy from a biological and clinical standpoint.