Granulocyte-colony-stimulating factor in acute myocardial infarction: future perspectives after FIRSTLINE-AMI and REVIVAL-2.

Granulocyte-colony-stimulating factor (G-CSF) seems to have direct cardioprotective effects related to mobilization of autologous bone-marrow mononuclear CD34(+) cells. These properties have attracted the attention of researchers investigating new therapeutic strategies for acute myocardial infarction. The role of G-CSF in bone-marrow cell mobilization removes the need for bone-marrow aspiration and repeated invasive procedures. This factor, coupled with the fact that G-CSF can be administered by noninvasive subcutaneous injection, give this approach a potential advantage over other cell-therapy options. This article is intended to present a concise overview of the current experimental and clinical findings for G-CSF therapy after acute myocardial infarction. In particular, we discuss the conflicting findings from the front-integrated revascularization and stem cell liberation in evolving acute myocardial infarction (FIRSTLINE-AMI) and the Regenerate Vital Myocardium by Vigorous Activation of Bone Marrow Stem Cells (REVIVAL-2) studies.