Several clinical angiogenesis trials have been conducted in patients with coronary artery disease. The investigators have either used synthesized recombinant vascular growth factor proteins or the genes encoding these proteins. Both methods have advantages and disadvantages. The optimal growth factor therapy to induce angio-genesis in ischemic myocardium can be defined as a therapy with 1) local accumulation of or stimulation of the production of growth factors, 2) to a certain therapeutic concentration, 3) for a certain appropriate period, 4) in an isolated ischemic tissue area, and 5) with a minimal overflow of growth factors into non-ischemic tissues far away from the tissue area of interest. The used growth factor formulations and the methods used for application of the treatment in clinical trials have fulfilled these demands to a varying degree.
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