BACKGROUND:Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with myocardial infarction. We examined the feasibility and efficacy of granulocyte-colony stimulating factor (G-CSF) therapy and subsequent intracoronary infusion of collected peripheral blood stem-cells (PBSCs) in such patients. METHODS: We prospectively randomised 27 patients with myocardial infarction who underwent coronary stenting for the culprit lesion of infarction into three groups; cell infusion (n=10), G-CSF alone (n=10), and control group (n=7). Changes in left ventricular systolic function and perfusion were assessed after 6 months. By December, 2003, seven patients from the cell infusion group, three from the G-CSF group, and one from the control group had been assessed. FINDINGS: G-CSF injection and intracoronary infusion of the mobilised PBSC did not aggravate inflammation and ischaemia during the periprocedural period. Exercise capacity (mean treadmill exercise time: 450 s [SD 178] at baseline vs 578 s [168] at 6 months' follow-up, p=0.004), myocardial perfusion (perfusion defect 11.6% [9.6] vs 5.3% [5.0], p=0.020) and systolic function (left ventricular ejection fraction 48.7% [8.3] vs 55.1% [7.4], p=0.005) improved significantly in patients who received cell infusion. However, we noted an unexpectedly high rate of in-stent restenosis at culprit lesion in patients who received G-CSF, and therefore we stopped enrollment. INTERPRETATION: G-CSF therapy with intracoronary infusion of PBSC showed improved cardiac function, and promoted angiogenesis in patients with myocardial infarction. However, aggravation of restenosis could be a serious problem. In future studies with G-CSF based stem-cell therapy, patients should be carefully monitored for unexpected effects.
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BACKGROUND: Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with myocardial infarction. We examined the feasibility and efficacy of granulocyte-colony stimulating factor (G-CSF) therapy and subsequent intracoronary infusion of collected peripheral blood stem-cells (PBSCs) in such patients. METHODS: We prospectively randomised 27 patients with myocardial infarction who underwent coronary stenting for the culprit lesion of infarction into three groups; cell infusion (n=10), G-CSF alone (n=10), and control group (n=7). Changes in left ventricular systolic function and perfusion were assessed after 6 months. By December, 2003, seven patients from the cell infusion group, three from the G-CSF group, and one from the control group had been assessed. FINDINGS:G-CSF injection and intracoronary infusion of the mobilised PBSC did not aggravate inflammation and ischaemia during the periprocedural period. Exercise capacity (mean treadmill exercise time: 450 s [SD 178] at baseline vs 578 s [168] at 6 months' follow-up, p=0.004), myocardial perfusion (perfusion defect 11.6% [9.6] vs 5.3% [5.0], p=0.020) and systolic function (left ventricular ejection fraction 48.7% [8.3] vs 55.1% [7.4], p=0.005) improved significantly in patients who received cell infusion. However, we noted an unexpectedly high rate of in-stent restenosis at culprit lesion in patients who received G-CSF, and therefore we stopped enrollment. INTERPRETATION:G-CSF therapy with intracoronary infusion of PBSC showed improved cardiac function, and promoted angiogenesis in patients with myocardial infarction. However, aggravation of restenosis could be a serious problem. In future studies with G-CSF based stem-cell therapy, patients should be carefully monitored for unexpected effects.
Authors: Anke M Smits; Patrick van Vliet; Rutger J Hassink; Marie-José Goumans; Pieter A Doevendans Journal: J Cell Mol Med Date: 2005 Jan-Mar Impact factor: 5.310
Authors: Katherine A Gallagher; Zhao-Jun Liu; Min Xiao; Haiying Chen; Lee J Goldstein; Donald G Buerk; April Nedeau; Stephen R Thom; Omaida C Velazquez Journal: J Clin Invest Date: 2007-05 Impact factor: 14.808