The Improvement of Myocardial Function by Granulocyte Colony Stimulating Factor Following Acute Anterior Myocardial Infarction: A Double Blind Placebo Controlled Study

Background: In patients with acute myocardial infarction (AMI),reperfusion of the occluded infarct-related artery significantly improves acuteand late clinical outcome. There is increasing evidence that transplantation ofautologous stem cells improves cardiac function after AMI. For propagation ofperipheral blood stem cells, application of granulocyte–colony stimulatingfactor (G-CSF) has been shown to be feasible, effective, and safe.Methods: Ten patients in the treatment group and 10 patients in thecontrol group were enrolled in this prospective, randomized controlled anddouble blind study. Two weeks after myocardial infarction that was followed bysuccessful recanalization and stent implantation, the patients of the treatmentgroup received 10 μg/kg body weight per day (divided BID) G-CSF subcutaneouslyfor a maximum duration of 5.0 days. In both groups, ejection fraction wasevaluated with echocardiography and cardiac perfusion scans 10 days and 6 monthsafter myocardial infarction. The Tei index was measured by echocardiography.Results: No severe side effects of G-CSF treatment were observed. Therewas no significant improvement of left ventricular ejection fraction when theG-CSF treated group was compared to the control group (P=0.821 for cardiac scanand P=0.705 for echocardiography). Changes in Tei index was not significant inthe treatment group(P=0.815); however, it was significantly deteriorated in the control group(P=0.005).Conclusion: In patients with acute anterior myocardial infarction,treatment with G-CSF, is feasible and safe and seems to be effective inimproving global cardiac function without affecting the ejection fraction underclinical conditions.