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 acute and late clinical outcome. There is increasing evidence that transplantation of autologous stem cells improves cardiac function after AMI. For propagation of peripheral blood stem cells, application of granulocyte–colony stimulating factor (G-CSF) has been shown to be feasible, effective, and safe.

Methods: Ten patients in the treatment group and 10 patients in the control group were enrolled in this prospective, randomized controlled and double blind study. Two weeks after myocardial infarction that was followed by successful recanalization and stent implantation, the patients of the treatment group received 10 μg/kg body weight per day (divided BID) G-CSF subcutaneously for a maximum duration of 5.0 days. In both groups, ejection fraction was evaluated with echocardiography and cardiac perfusion scans 10 days and 6 months after myocardial infarction. The Tei index was measured by echocardiography.

Results: No severe side effects of G-CSF treatment were observed. There was no significant improvement of left ventricular ejection fraction when the G-CSF treated group was compared to the control group (P=0.821 for cardiac scan and P=0.705 for echocardiography). Changes in Tei index was not significant in the 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 in improving global cardiac function without affecting the ejection fraction under clinical conditions.