title: Pharmacological treatment of coronary artery disease with recombinant fibroblast growth factor-2: double-blind, randomized, controlled clinical trial.
abstract: BACKGROUND
  Single-bolus intracoronary administration of fibroblast growth factor-2 (FGF2) improved symptoms and myocardial function in a phase I, open-label trial in patients with coronary artery disease. We conducted the FGF Initiating RevaScularization Trial (FIRST) to evaluate further the efficacy and safety of recombinant FGF2 (rFGF2).
  
  
  RESULTS
  FIRST is a multicenter, randomized, double-blind, placebo-controlled trial of a single intracoronary infusion of rFGF2 at 0, 0.3, 3, or 30 microg/kg (n=337 patients). Efficacy was evaluated at 90 and 180 days by exercise tolerance test, myocardial nuclear perfusion imaging, Seattle Angina Questionnaire, and Short-Form 36 questionnaire. Exercise tolerance was increased at 90 days in all groups and was not significantly different between placebo and FGF-treated groups. rFGF2 reduced angina symptoms as measured by the angina frequency score of the Seattle Angina Questionnaire (overall P=0.035) and the physical component summary scale of the Short-Form 36 (pairwise P=0.033, all FGF groups versus placebo). These differences were more pronounced in highly symptomatic patients (baseline angina frequency score < or =40 or Canadian Cardiovascular Society score of III or IV). None of the differences were significant at 180 days because of continued improvement in the placebo group. Adverse events were similar across all groups, except for hypotension, which occurred with higher frequency in the 30-microg/kg rFGF2 group.
  
  
  CONCLUSIONS
  A single intracoronary infusion of rFGF2 does not improve exercise tolerance or myocardial perfusion but does show trends toward symptomatic improvement at 90 (but not 180) days.
authors.affiliation: Section of Cardiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA. Michael.Simons@Dartmouth.edu
authors.forename: Michael
authors.initials: M
authors.lastname: Simons
authors.forename: Brian H
authors.initials: BH
authors.lastname: Annex
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Laham
authors.forename: Neal
authors.initials: N
authors.lastname: Kleiman
authors.forename: Timothy
authors.initials: T
authors.lastname: Henry
authors.forename: Harold
authors.initials: H
authors.lastname: Dauerman
authors.forename: James E
authors.initials: JE
authors.lastname: Udelson
authors.forename: Ernesto V
authors.initials: EV
authors.lastname: Gervino
authors.forename: Marilyn
authors.initials: M
authors.lastname: Pike
authors.forename: M J
authors.initials: MJ
authors.lastname: Whitehouse
authors.forename: Thomas
authors.initials: T
authors.lastname: Moon
authors.forename: Nicolas A
authors.initials: NA
authors.lastname: Chronos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy*; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy*; D003326:Coronary Circulation / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000008:administration & dosage* / Q000009:adverse effects; D006304:Health Status; D006801:Humans; D007022:Hypotension / Q000209:etiology; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage* / Q000009:adverse effects; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D016222:Fibroblast Growth Factor 2