European Heart Journal Advance Access published online on April 28, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi289
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1 Section of Cardiology, University of Ferrara and Cardiovascular Research Centre, Arcispedale S. Anna C.rso Giovecca 203, 44100 Ferrara, Italy
* To whom correspondence should be addressed. 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.
Received November 5, 2004
Revised February 28, 2005
Accepted March 24, 2005
Clinical research
Use of granulocyte-colony stimulating factor during acute myocardial infarction to enhance bone marrow stem cell mobilization in humans: clinical and angiographic safety profile
2 Section of Hematology, University of Ferrara, Ferrara, Italy
3 Section of Nuclear Medicine, University of Ferrara, Ferrara, Italy
4 Third Laboratory, Spedali Civili, Brescia, Italy
Marco Valgimigli, E-mail: vlgmrc{at}unife.it
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