Treatment with granulocyte colony–stimulating factor for mobilization of bone marrow cells in patients with acute myocardial infarction

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 μg/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. Conclusion 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.