Effect of granulocyte colony-stimulating factor treatment at a low dose but for a long duration in patients with coronary heart disease.
BACKGROUND
In animal models, granulocyte colony-stimulating factor (G-CSF) improves post-infarct cardiac function. However, in pilot studies involving patients with angina and acute myocardial infarction (AMI), G-CSF at a high dose frequently induced coronary occlusion or restenosis, but those at a low dose showed no significant beneficial effect. We hypothesized that a low dose but long duration of G-CSF will have a beneficial effect without serious complications to patients with coronary heart disease.


RESULTS
Forty-six patients with angina or AMI were randomly assigned into G-CSF and non-G-CSF control groups, respectively. Recombinant G-CSF was subcutaneously injected once a day for 10 days. The leukocyte counts in the peripheral blood were controlled at approximately 30,000/microl. One month later, a Thallium-201 single photon emission computed tomography revealed the increased percentage uptake and the reduced extent and severity scores in the G-CSF angina group. In the G-CSF AMI group, the curve between the ejection fraction and peak creatine kinase shifted significantly upward, compared with that of the non-G-CSF AMI group. Serious complications were not observed during the 6 months of observation.


CONCLUSIONS
A low dose but long duration of G-CSF treatment may have a beneficial effect without any serious complications in patients with coronary heart disease.
Department of Cardiology, Gifu University Graduate School of Medicine, Yanagido, Japan.
Koji
K
Suzuki
Kenshi
K
Nagashima
Masazumi
M
Arai
Yoshihiro
Y
Uno
Yu
Y
Misao
Genzou
G
Takemura
Kazuhiko
K
Nishigaki
Shinya
S
Minatoguchi
Sachiro
S
Watanabe
Chuwa
C
Tei
Hisayoshi
H
Fujiwara
D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D018952:Antigens, CD34 / Q000097:blood; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D000078224:Lenograstim; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D013997:Time Factors; D016277:Ventricular Function, Left / Q000502:physiology
D018952:Antigens, CD34; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000078224:Lenograstim