title: Treatment with granulocyte colony-stimulating factor for mobilization of bone marrow cells in patients with acute myocardial infarction.
abstract: BACKGROUND
  This study was undertaken to evaluate the hypothesis that treatment with granulocyte colony-stimulating factor (G-CSF) to mobilize bone marrow cells (BMCs) is feasible and safe and promotes neovascularization and myocardial function in patients with acute myocardial infarction.
  
  
  METHODS
  Fourteen patients in the treatment group and 9 patients in the control group were enrolled in this prospective, nonrandomized, open-label study. Forty-eight hours after successful recanalization and stent implantation, the patients of the treatment group received 10 microg/kg body weight per day G-CSF subcutaneously for mean treatment duration of 7.0 +/- 1.0 days. Nine patients fulfilled the entry criteria but refused participation and served therefore as control group. In both groups, regional wall motion and perfusion was evaluated with electrocardiogram-gated sestamibi single-photon emission computed tomography imaging and ejection fraction with radionuclidventriculography before discharge and after 3 months.
  
  
  RESULTS
  No severe side effects of G-CSF treatment were observed. There was a significant improvement of the regional wall motion and perfusion within the treatment group (P < .0001) and between the treatment and control group (P < .05 and P < .01, respectively). Ejection fraction in the treatment group increased from 0.40 +/- 0.11 to 0.48 +/- 0.13 (P < .01), whereas in the control group, ejection fraction increased from 0.40 +/- 0.13 to 0.43 +/- 0.13 (P = .049). A control angiography of the treatment group after 12.4 +/- 6.6 months showed an in-stent restenosis in 1 patient.
  
  
  CONCLUSIONS
  In patients with acute myocardial infarction, treatment with G-CSF to mobilize BMCs is feasible and safe and seems to be effective under clinical conditions. The therapeutic effect might be attributed to BMC-associated promotion of myocardial regeneration and neovascularization.
authors.affiliation: Klinik fuer Innere Medizin I, Friedrich-Schiller-Universitaet Jena, Jena, Germany. friedhelm.kuethe@med.uni-jena.de
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Kuethe
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
authors.forename: Michael
authors.initials: M
authors.lastname: Herzau
authors.forename: Matthias
authors.initials: M
authors.lastname: Voth
authors.forename: Michael
authors.initials: M
authors.lastname: Fritzenwanger
authors.forename: Thomas
authors.initials: T
authors.lastname: Opfermann
authors.forename: Katharina
authors.initials: K
authors.lastname: Pachmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Krack
authors.forename: Herbert G
authors.initials: HG
authors.lastname: Sayer
authors.forename: Dietmar
authors.initials: D
authors.lastname: Gottschild
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Werner
mesh_terms: D005240:Feasibility Studies; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D011446:Prospective Studies
chemical_list: D016179:Granulocyte Colony-Stimulating Factor