Usefulness of Hyper Early Granulocyte-colony-stimulating Factor Therapy for Patients with Acute Myocardial Infarction

Objective: It has been reported that granulocyte-colony-stimulating-factor (G-CSF) induces myocardial regeneration and revascularization after acute myocardial infarction (AMI) by mobilizing bone marrow stem cells and suppressing apoptosis of endothelial cells in the injured heart. This study investigated whether hyper early G-CSF therapy was beneficial for AMI patients. Methods: Forty consecutive patients with initial ST-segment elevation AMI were randomized to receive intravenous infusion of G-CSF at 2μg/kg over 30 min (G-CSF group) or infusion of normal saline (control group) once daily for 5 days. The first dose was administered during primary percutaneous coronary intervention just after hospitalization. In the subacute period and 6 months after AMI, all patients underwent myocardial scintigraphy, including 99m Tc-sestamibi imaging of myocardial perfusion and 123 I-beta-methyl-piodophenylpentadecanoic-acid ( 123 I-BMIPP) imaging to assess fatty acid metabolism. Results: The two groups had a similar myocardial area at risk, as evaluated by the extent score on subacute 123 IBMIPP imaging. Compared with the control group, the G-CSF group had a significantly smaller (p<0.05) total defect score on 99m Tc-sestamibi and 123 I-BMIPP imaging at 6 months. In addition, the left ventricular ejection fraction and regional wall motion score were larger in the G-CSF group than in the control group during the subacute period and after 6 months. Conclusions: Hyper early G-CSF therapy improves myocardial perfusion, fatty acid metabolism, and cardiac function after AMI.