Stem Cell Therapy for Acute Myocardial Infarction and Cardiomyopathy: The Emergency Medicine Perspective

Ischemic cardiovascular disease remains the leading cause of death worldwide. Patients with acute myocardial infarction and cardiomyopathy are commonly treated in the emergency department, with emphasis on pharmacologic stabilization, thrombolysis, and expeditious transfer to percutaneous coronary intervention and/or the inpatient cardiac unit. The nexus between emergency medicine and regenerative medicine, which focuses on repair and restoration of damaged tissue, is just beginning. The use of stem cells, which are capable of extensive proliferation and differentiation into myriad lineage cells, are a key component of regenerative medicine. Over the past two decades, stem cell research has expanded and demonstrated benefit in animal and human studies of acute myocardial infarction and cardiomyopathy. However, stem cell treatment must be initiated early to achieve the best outcome. Emergency physicians may soon be involved in this regenerative process, with procurement and administration of stem cells during the initial stabilization of the acute cardiac patient in the emergency department. In this article, we discuss the emergency medicine perspective on the selection of specific types of stem cells and their adjuncts, route, timing, mechanisms of healing, relevant clinical scenarios, and review the evidence and safety behind this futuristic treatment.