title: Effects of intracoronary infusion of peripheral blood stem-cells mobilised with granulocyte-colony stimulating factor on left ventricular systolic function and restenosis after coronary stenting in myocardial infarction: the MAGIC cell randomised clinical trial.
abstract: 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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.affiliation: Cardiovascular Laboratory, Clinical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyun-Jae
authors.initials: HJ
authors.lastname: Kang
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Shu-Ying
authors.initials: SY
authors.lastname: Zhang
authors.forename: Kyung-Woo
authors.initials: KW
authors.lastname: Park
authors.forename: Hyun-Jai
authors.initials: HJ
authors.lastname: Cho
authors.forename: Bon-Kwon
authors.initials: BK
authors.lastname: Koo
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong
authors.initials: D
authors.lastname: Soo Lee
authors.forename: Dae-Won
authors.initials: DW
authors.lastname: Sohn
authors.forename: Kyou-Sup
authors.initials: KS
authors.lastname: Han
authors.forename: Byung-Hee
authors.initials: BH
authors.lastname: Oh
authors.forename: Myoung-Mook
authors.initials: MM
authors.lastname: Lee
authors.forename: Young-Bae
authors.initials: YB
authors.lastname: Park
mesh_terms: D001158:Arteries / Q000601:surgery; D003131:Combined Modality Therapy; D023903:Coronary Restenosis / Q000209:etiology*; D003331:Coronary Vessels / Q000601:surgery*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery* / Q000628:therapy*; D018919:Neovascularization, Physiologic / Q000502:physiology; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D015607:Stents; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor