title: Effects of peripheral blood stem cell mobilization with granulocyte-colony stimulating factor and their transcoronary transplantation after primary stent implantation for acute myocardial infarction.
abstract: BACKGROUND
  There is increasing evidence that transplantation of autologous stem cells improves cardiac function after acute myocardial infarction (AMI). For propagation of peripheral blood stem cells (PBSCs), application of granulocyte-colony stimulating factor (G-CSF) has been shown to be feasible, effective, and safe. We sought to evaluate a clinical and angiographic long-term safety profile of G-CSF application combined with transcoronary PBSC transplantation after recent stent implantation for AMI.
  
  
  METHODS
  In patients with AMI and successful primary stenting of the infarct-related coronary artery, pharmacological bone marrow stimulation with G-CSF was initiated on the second postinterventional day. At least after 4 days of G-CSF therapy, apheresis as well as transcoronary transplantation of PBSCs was performed. The PBSCs were infused via a balloon catheter which was inflated inside the stent. Ventriculography and quantitative coronary angiography were performed at baseline and after 6 months.
  
  
  RESULTS
  In the 20 patients who received PBSCs, mean left ventricular ejection fraction improved from 46.4% +/- 8.1% at baseline to 54.3% +/- 11% after 6 months (P < .001) because of an increase in systolic function in the infarct region. Control coronary angiography revealed a significant in-stent restenosis of the infarct-related coronary artery, defined as >50% stenosis, in 8 patients (40%), which was complicated by reinfarction in 2 patients (10%).
  
  
  CONCLUSIONS
  Transcoronary transplantation of G-CSF-mobilized PBSCs favorably influences cardiac function and can be performed without adverse periprocedural events. However, significant in-stent restenosis and reinfarction seem to occur frequently during the following 6 months.
authors.affiliation: Cardiovascular Division, City Hospital Linz, Linz, Austria. clemens.steinwender@akh.linz.at
authors.forename: Clemens
authors.initials: C
authors.lastname: Steinwender
authors.forename: Robert
authors.initials: R
authors.lastname: Hofmann
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kammler
authors.forename: Alexander
authors.initials: A
authors.lastname: Kypta
authors.forename: Robert
authors.initials: R
authors.lastname: Pichler
authors.forename: Wilma
authors.initials: W
authors.lastname: Maschek
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuster
authors.forename: Christian
authors.initials: C
authors.lastname: Gabriel
authors.forename: Franz
authors.initials: F
authors.lastname: Leisch
mesh_terms: D003131:Combined Modality Therapy; 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; D015607:Stents
chemical_list: D016179:Granulocyte Colony-Stimulating Factor