Why the study?
Although G-CSF was reported to induce myocardial regeneration and revascularization after AMI, whether hyper early G-CSF therapy was beneficial remained uninvestigated.
Does hyper early G-CSF therapy improve myocardial perfusion and cardiac function in patients with initial ST-segment elevation acute myocardial infarction?
Does hyper early G-CSF therapy improve myocardial perfusion and cardiac function in patients with initial ST-segment elevation acute myocardial infarction?
Hyper early administration of G-CSF during primary PCI for STEMI significantly improves myocardial perfusion, fatty acid metabolism, and left ventricular ejection fraction at 6 months.
Supports adjunctive hyper-early G-CSF during primary PCI for STEMI; extends randomized evidence on perfusion and function.
Objective: It has been reported that granulocyte-colony-stimulating-factor (G-CSF) induces myocardial regeneration and revascularization after acute myocardial infarction (AMI) by mobilizing bone marrow stem cells and suppressing apoptosis of endothelial cells in the injured heart. This study investigated whether hyper early G-CSF therapy was beneficial for AMI patients.Methods: Forty consecutive patients with initial ST-segment elevation AMI were randomized to receive intravenous infusion of G-CSF at 2μg/kg over 30 min (G-CSF group) or infusion of normal saline (control group) once daily for 5 days. The first dose was administered during primary percutaneous coronary intervention just after hospitalization. In the subacute period and 6 months after AMI, all patients underwent myocardial scintigraphy, including 99mTc-sestamibi imaging of myocardial perfusion and 123I-beta-methyl-p-iodophenylpentadecanoic-acid (123I-BMIPP) imaging to assess fatty acid metabolism.Results: The two groups had a similar myocardial area at risk, as evaluated by the extent score on subacute 123I-BMIPP imaging. Compared with the control group, the G-CSF group had a significantly smaller (p<0.05) total defect score on 99mTc-sestamibi and 123I-BMIPP imaging at 6 months. In addition, the left ventricular ejection fraction and regional wall motion score were larger in the G-CSF group than in the control group during the subacute period and after 6 months.Conclusions: Hyper early G-CSF therapy improves myocardial perfusion, fatty acid metabolism, and cardiac function after AMI.
No takes yet. Share an insight, caveat, or question.
Toyama et al. (2019) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: