[Effects of stem-cell mobilization with recombinant human granulocyte colony stimulating factor in patients with percutaneously revascularized acute anterior myocardial infarction].
OBJECTIVE
This study reports the findings in a group of 13 patients aged 53+/-8 years with anterior wall acute myocardial infarction who were revascularized with stents and treated with recombinant human granulocyte colony stimulating factor (G-CSF).


METHODS
Patients were initially treated with intravenous thrombolytics. The first cardiac catheterization was performed between days 0 and 5 after acute myocardial infarction, when the left anterior descending artery was stented. A 10-day course of 10 .g/kg/day G-CSF was started 5 days after acute myocardial infarction. Blood cell counts and immunophenotyping were done to assess the total number of circulating CD34+ cells and their subpopulations in serial fashion. At 3-month follow-up, cardiac catheterization was repeated. Functional recovery was defined as an increase in ejection fraction.


RESULTS
All patients did well initially, but 1 had spontaneous spleen rupture on day 8 of G-CSF administration, which required emergency splenectomy. The gain in ejection fraction varied among patients from -22 to +18 (mean, 6.2%+/-12%), and correlated directly with the total number of circulating CD34+ CD38- cells/microL on the fifth day of G-CSF treatment (r=0.78; P<.003). The gain in ejection fraction correlated inversely with peak MB fraction creatine kinase (r=-0.82; P<.002).


CONCLUSIONS
Stem-cell mobilization with G-CSF is a feasible and safe treatment for patients with revascularized acute myocardial infarction. However, because of the possibility of acute splenitis induced by massive cell mobilization, future studies should be designed with due caution to take this eventuality into account.
Suárez de Lezo
José
J
Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain. grupo_corpal@arrakis.es
Torres
Antonio
A
Herrera
Inmaculada
I
Pan
Manuel
M
Romero
Miguel
M
Pavlovic
Djordje
D
Segura
José
J
Ojeda
Soledad
S
Sánchez
Joaquín
J
López Rubio
Fernando
F
Medina
Alfonso
A
D003131:Combined Modality Therapy; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy*; D011446:Prospective Studies; D011994:Recombinant Proteins; D020127:Recovery of Function; D033581:Stem Cell Transplantation
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor