Details

Autor(en) / Beteiligte

• Leone, Antonio Maria, MD
• Galiuto, Leonarda, MD
• Garramone, Barbara, MD
• Rutella, Sergio, MD, PhD
• Giannico, Maria Benedetta, MD
• Brugaletta, Salvatore, MD
• Perfetti, Matteo, MD
• Liuzzo, Giovanna, MD
• Porto, Italo, MD, PhD
• Burzotta, Francesco, MD, PhD
• Niccoli, Giampaolo, MD, PhD
• Biasucci, Luigi Marzio, MD
• Leone, Giuseppe, MD
• Rebuzzi, Antonio Giuseppe, MD
• Crea, Filippo, MD

Titel

Usefulness of Granulocyte Colony-Stimulating Factor in Patients With a Large Anterior Wall Acute Myocardial Infarction to Prevent Left Ventricular Remodeling (The Rigenera Study)

Ist Teil von

• The American journal of cardiology, 2007-08, Vol.100 (3), p.397-403

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• Intracoronary injection of bone marrow stem cells seems to improve left ventricular (LV) function after acute myocardial infarction (AMI). Granulocyte colony-stimulating factor (G-CSF) could improve myocardial function and perfusion noninvasively through mobilization of stem cells into peripheral blood, although previous clinical trials have produced controversial results. Forty-one patients with large anterior wall AMI at high risk of unfavorable remodeling were randomized 1:2 to G-CSF (10 μg/kg/day for 5 days) or to conventional therapy. All patients underwent successful primary or rescue percutaneous coronary intervention. LV function was assessed by echocardiography before G-CSF administration, ≥5 days after AMI, and at follow-up. Only patients with a LV ejection fraction <50% at baseline were enrolled in the study. After a median follow-up of 5 months (range 4 to 6) patients treated with G-CSF exhibited improvement in LV ejection fraction, from 40 ± 6% to 45 ± 6% (p = 0.068) in the absence of LV dilation (LV end-diastolic volume from 147 ± 33 to 144 ± 46 ml at follow-up, p = 0.77). In contrast, patients treated conventionally exhibited significant LV dilation (LV end-diastolic volume from 141 ± 35 to 168 ± 41 ml, p = 0.002) in the absence of change in LV ejection fraction (from 38 ± 6% to 38 ± 8%, p = 0.95). However, when comparing patients treated with G-CSF with controls, variations in these parameters were significantly different at 2-way analysis of variance (p = 0.04 for LV end-diastolic volume, p = 0.02 for LV ejection fraction). In conclusion, G-CSF prevents unfavorable LV remodeling and improves LV function in patients with large anterior wall AMI and decreased LV ejection fraction after successful percutaneous coronary intervention.