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- AMI, acute myocardial infarction
- CRP, C reactive protein
- G-CSF, granulocyte-colony-stimulating factor
- IRA, infarct-related artery
- MLD, minimal lumen diameter
- PCI, percutaneous coronary intervention
- SPECT, single photon emission computed tomography
Intracoronary administration of bone marrow stem cells can improve left ventricular function after acute myocardial infarction (AMI)1; however, it is invasive and therefore not widely applicable. Moreover, we have recently shown that the CD34 cell count is favourably correlated with left ventricular function changes after AMI.2 Granulocyte-colony stimulating factor (G-CSF), a potent mobiliser of CD34 stem cells, might improve left ventricular function through their increased concentration.
Yet, a recent report raised concern about the safety of early G-CSF administration after AMI, followed by intracoronary cell injection and infarct-related artery (IRA) stenting, because of a strikingly high restenosis rate.3
The aim of our study was to assess the safety and the potential efficacy on cardiac function and perfusion of G-CSF administration in patients with a first large AMI.
We enrolled eight patients with a first anterior AMI (all men, mean (standard deviation (SD)) age 54 (11) years, peak creatinine kinase 4615 (3998) UI/l). Successful stenting of IRA within 7 days and left ventricular ejection fraction <45%. Exclusion criteria were cardiogenic shock, uncontrolled myocardial ischaemia or arrhythmias, malignancies, severe infections, haematological diseases, splenomegaly at abdominal echography and age >80 years. All patients were treated with lenograstim (recombinant human G-CSF) at a dose of 10 μg/kg/day for 5 days starting 5 days after coronary stenting. During hospitalisation and at 3 and 6 months, the occurrence of major adverse cardiac events (death, re-infarction and recurrence of angina) and myocardial …
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