European Heart Journal Advance Access originally published online on April 28, 2005
European Heart Journal 2005 26(18):1838-1845; doi:10.1093/eurheartj/ehi289
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Use of granulocyte-colony stimulating factor during acute myocardial infarction to enhance bone marrow stem cell mobilization in humans: clinical and angiographic safety profile
1Section of Cardiology, University of Ferrara and Cardiovascular Research Centre, Arcispedale S. Anna C.rso Giovecca 203, 44100 Ferrara, Italy
2Section of Hematology, University of Ferrara, Ferrara, Italy
3Section of Nuclear Medicine, University of Ferrara, Ferrara, Italy
4Third Laboratory, Spedali Civili, Brescia, Italy
Received 5 November 2004; revised 28 February 2005; accepted 24 March 2005; online publish-ahead-of-print 28 April 2005.
* Corresponding author. Tel: +39 0532 202143; fax: +39 0532 241885. E-mail address: vlgmrc{at}unife.it
Aims There is increasing evidence that stem cell (SC) mobilization to the heart and their differentiation into cardiac cells is a naturally occurring process. We sought to assess the safety and feasibility of granulocyte-colony stimulating factor (G-CSF) administration in humans to enhance SC mobilization and left ventricle (LV) injury repair during myocardial infarction (MI).
Methods and results Twenty patients with STEMI (mean age, 61±10 years), of whom 14 were submitted to primary percutaneous coronary intervention, were randomized to G-CSF (5 µg/kg/day s.c. for 4 consecutive days) or placebo. At entry and then at months 3 and 6, 99mTc-sestamibi gated-SPECT was performed to estimate extension of perfusion defect (PD) and LV function. The study drug was well tolerated and induced a significant increase of white blood count, CD34+ cells, and CD34+ cells coexpressing AC133 and VEGFR-2. At follow-up, treated and placebo groups did not differ for the angiographic coronary late loss and showed a similar pattern of PD recovery, whereas in the former at 6 months LVEF and especially LVEDV tended to be relatively higher (P=0.068) and lower (P=0.054), respectively.
Conclusion G-CSF administration in acute MI patients was feasible and did not lead to any clinical or angiographic adverse events and resulted in CD34+ and CD34+AC133+VEGFR2+ cell mobilization.
Key Words: Endothelial progenitor cells • Myocardial infarction • CD34 • Granulocyte-colony stimulating factor
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