TY - JOUR
T1 - Timing of granulocyte-colony stimulating factor treatment after acute myocardial infarction and recovery of left ventricular function
T2 - results from the STEMMI trial
AU - Overgaard, Mikkel
AU - Ripa, Rasmus Sejersten
AU - Wang, Yongzhong
AU - Jørgensen, Erik
AU - Kastrup, Jens
N1 - Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.
PY - 2010/4/30
Y1 - 2010/4/30
N2 - Background: Granulocyte-colony stimulating factor (G-CSF) therapy after ST-elevation myocardial infarction (STEMI) have not demonstrated impact on systolic recovery compared to placebo. However, recent studies suggest that timing of G-CSF therapy is crucial. Methods: Timing of G-CSF treatment was analyzed in the STEMMI MRI subpopulation including 54 patients with STEMI treated with primary percutaneous coronary intervention (PCI) b12 h after symptom onset. Patients were randomized to double blind treatment with GCSF (10 μg/kg/day) or placebo. Treatment was initiated from 17 to 65 h (mean 30) after PCI. Left ventricular ejection fraction (LVEF) was evaluated with MRI. Results: Recovery of LVEF from baseline to 6 months was not associated with time from PCI to G-CSF. An identical improvement in LVEF was found in the placebo group and the G-CSF group (p=0.8). There was no correlation between time from PCI to G-CSF and maximum plasma concentration of CD34+ cells (r=-0.3, p=0.1). Similar results were found from data on recovery of the infarction size and change in the systolic wall thickening. Conclusions: In the time window from 17 to 65 h after STEMI treated with PCI, the timing of G-CSF treatment does not seem to affect the recovery of LVEF. It remains to be determined if very early, or very late G-CSF treatment might be effective.
AB - Background: Granulocyte-colony stimulating factor (G-CSF) therapy after ST-elevation myocardial infarction (STEMI) have not demonstrated impact on systolic recovery compared to placebo. However, recent studies suggest that timing of G-CSF therapy is crucial. Methods: Timing of G-CSF treatment was analyzed in the STEMMI MRI subpopulation including 54 patients with STEMI treated with primary percutaneous coronary intervention (PCI) b12 h after symptom onset. Patients were randomized to double blind treatment with GCSF (10 μg/kg/day) or placebo. Treatment was initiated from 17 to 65 h (mean 30) after PCI. Left ventricular ejection fraction (LVEF) was evaluated with MRI. Results: Recovery of LVEF from baseline to 6 months was not associated with time from PCI to G-CSF. An identical improvement in LVEF was found in the placebo group and the G-CSF group (p=0.8). There was no correlation between time from PCI to G-CSF and maximum plasma concentration of CD34+ cells (r=-0.3, p=0.1). Similar results were found from data on recovery of the infarction size and change in the systolic wall thickening. Conclusions: In the time window from 17 to 65 h after STEMI treated with PCI, the timing of G-CSF treatment does not seem to affect the recovery of LVEF. It remains to be determined if very early, or very late G-CSF treatment might be effective.
KW - Angioplasty, Balloon, Coronary
KW - Combined Modality Therapy
KW - Double-Blind Method
KW - Female
KW - Granulocyte Colony-Stimulating Factor
KW - Humans
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Myocardial Infarction
KW - Prospective Studies
KW - Recombinant Proteins
KW - Recovery of Function
KW - Time Factors
KW - Ventricular Function, Left
U2 - 10.1016/j.ijcard.2008.11.120
DO - 10.1016/j.ijcard.2008.11.120
M3 - Journal article
C2 - 19131132
SN - 0167-5273
VL - 140
SP - 351
EP - 355
JO - International Journal of Cardiology
JF - International Journal of Cardiology
IS - 3
ER -