Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial

Erik Jørgensen; Federica Baldazzi; Rasmus Sejersten Ripa; Tina Friis; Yongzong Wang; Steffen Helqvist; Jens Kastrup

doi:10.1016/j.ijcard.2008.10.029

Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial

Erik Jørgensen, Federica Baldazzi, Rasmus Sejersten Ripa, Tina Friis, Yongzong Wang, Steffen Helqvist, Jens Kastrup

6 Citations (Scopus)

Abstract

Background: Recombinant granulocyte-colony stimulating factor (G-CSF) mobilized pluripotent cells from the bone marrow are proposed to have a regenerative potential. Though, a report of excessive instent restenosis, in patients treated with G-CSF before percutaneous coronary intervention (PCI) warrants caution. Methods: Patients (n=59) enrolled in the STEMMI trial, a randomized and double blind study, comparing G-CSF and placebo after large ST-elevation myocardial infarctions, had an intracoronary ultrasound imaging at 6 months follow-up with a quantitative analysis of instent neointimal hyperplasia. Results: During G-CSF treatment leukocyte counts, and CD34+ and CD45-/CD34- cell fractions in peripheral blood increased markedly (p<0.0001 vs. placebo). At follow-up, there were no differences in intracoronary late lumen loss, expressed as neointima volume per mm of stent (1.6 mm ³±1.2 [G-CSF group] vs. 1.9 mm³ ±1.3 [placebo group]; p=0.38), and in minimal instent lumen area (5.4 mm² ±2.4 vs. 5.3 mm²±2.6, p=0.90). In the placebo group, plasma concentration of stromal cell-derived factor-1 (SDF-1) increased significantly after STEMI. This SDF-1 response was completely suppressed during G-CSF treatment. A rebound increase of SDF-1 was observed after withdrawal of G-CSF (p=0.001). Plasma concentration of SDF-1 at the time of stent implantation correlated positively to neointimal hyperplasia (p=0.025). Conclusions: G-CSF treatment, initiated after PCI, does not lead to excessive instent neointimal hyperplasia or restenosis in patients with STEMI. The timing of G-CSF, in relation to the PCI, might be important, as G-CSF influences SDF-1.

Original language	English
Journal	International Journal of Cardiology
Volume	139
Issue number	3
Pages (from-to)	269-75
Number of pages	7
ISSN	0167-5273
DOIs	https://doi.org/10.1016/j.ijcard.2008.10.029
Publication status	Published - 18 Mar 2010
Externally published	Yes

Keywords

Aged
Angioplasty, Balloon, Coronary
Double-Blind Method
Female
Follow-Up Studies
Granulocyte Colony-Stimulating Factor
Hematopoietic Stem Cell Mobilization
Humans
Hyperplasia
Male
Mesenchymal Stromal Cells
Middle Aged
Myocardial Infarction
Neointima
Prospective Studies
Recombinant Proteins
Stents
Treatment Outcome

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Jørgensen, E., Baldazzi, F., Ripa, R. S., Friis, T., Wang, Y., Helqvist, S., & Kastrup, J. (2010). Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial. International Journal of Cardiology, 139(3), 269-75. https://doi.org/10.1016/j.ijcard.2008.10.029

Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial. / Jørgensen, Erik; Baldazzi, Federica; Ripa, Rasmus Sejersten et al.

In: International Journal of Cardiology, Vol. 139, No. 3, 18.03.2010, p. 269-75.

Research output: Contribution to journal › Journal article › Research › peer-review

Jørgensen, E, Baldazzi, F, Ripa, RS, Friis, T, Wang, Y, Helqvist, S & Kastrup, J 2010, 'Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial', International Journal of Cardiology, vol. 139, no. 3, pp. 269-75. https://doi.org/10.1016/j.ijcard.2008.10.029

Jørgensen E, Baldazzi F, Ripa RS, Friis T, Wang Y, Helqvist S et al. Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial. International Journal of Cardiology. 2010 Mar 18;139(3):269-75. doi: 10.1016/j.ijcard.2008.10.029

Jørgensen, Erik ; Baldazzi, Federica ; Ripa, Rasmus Sejersten et al. / Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial. In: International Journal of Cardiology. 2010 ; Vol. 139, No. 3. pp. 269-75.

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title = "Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial",

abstract = "Background: Recombinant granulocyte-colony stimulating factor (G-CSF) mobilized pluripotent cells from the bone marrow are proposed to have a regenerative potential. Though, a report of excessive instent restenosis, in patients treated with G-CSF before percutaneous coronary intervention (PCI) warrants caution. Methods: Patients (n=59) enrolled in the STEMMI trial, a randomized and double blind study, comparing G-CSF and placebo after large ST-elevation myocardial infarctions, had an intracoronary ultrasound imaging at 6 months follow-up with a quantitative analysis of instent neointimal hyperplasia. Results: During G-CSF treatment leukocyte counts, and CD34+ and CD45-/CD34- cell fractions in peripheral blood increased markedly (p<0.0001 vs. placebo). At follow-up, there were no differences in intracoronary late lumen loss, expressed as neointima volume per mm of stent (1.6 mm 3±1.2 [G-CSF group] vs. 1.9 mm3 ±1.3 [placebo group]; p=0.38), and in minimal instent lumen area (5.4 mm2 ±2.4 vs. 5.3 mm2±2.6, p=0.90). In the placebo group, plasma concentration of stromal cell-derived factor-1 (SDF-1) increased significantly after STEMI. This SDF-1 response was completely suppressed during G-CSF treatment. A rebound increase of SDF-1 was observed after withdrawal of G-CSF (p=0.001). Plasma concentration of SDF-1 at the time of stent implantation correlated positively to neointimal hyperplasia (p=0.025). Conclusions: G-CSF treatment, initiated after PCI, does not lead to excessive instent neointimal hyperplasia or restenosis in patients with STEMI. The timing of G-CSF, in relation to the PCI, might be important, as G-CSF influences SDF-1.",

keywords = "Aged, Angioplasty, Balloon, Coronary, Double-Blind Method, Female, Follow-Up Studies, Granulocyte Colony-Stimulating Factor, Hematopoietic Stem Cell Mobilization, Humans, Hyperplasia, Male, Mesenchymal Stromal Cells, Middle Aged, Myocardial Infarction, Neointima, Prospective Studies, Recombinant Proteins, Stents, Treatment Outcome",

author = "Erik J{\o}rgensen and Federica Baldazzi and Ripa, {Rasmus Sejersten} and Tina Friis and Yongzong Wang and Steffen Helqvist and Jens Kastrup",

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doi = "10.1016/j.ijcard.2008.10.029",

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T1 - Instent neointimal hyperplasia after percutaneous intervention for ST-elevation myocardial infarction and treatment with granulocyte-colony stimulating factor. Results from the stem cells in myocardial infarction (STEMMI) trial

AU - Jørgensen, Erik

AU - Baldazzi, Federica

AU - Ripa, Rasmus Sejersten

AU - Friis, Tina

AU - Wang, Yongzong

AU - Helqvist, Steffen

AU - Kastrup, Jens

PY - 2010/3/18

Y1 - 2010/3/18

N2 - Background: Recombinant granulocyte-colony stimulating factor (G-CSF) mobilized pluripotent cells from the bone marrow are proposed to have a regenerative potential. Though, a report of excessive instent restenosis, in patients treated with G-CSF before percutaneous coronary intervention (PCI) warrants caution. Methods: Patients (n=59) enrolled in the STEMMI trial, a randomized and double blind study, comparing G-CSF and placebo after large ST-elevation myocardial infarctions, had an intracoronary ultrasound imaging at 6 months follow-up with a quantitative analysis of instent neointimal hyperplasia. Results: During G-CSF treatment leukocyte counts, and CD34+ and CD45-/CD34- cell fractions in peripheral blood increased markedly (p<0.0001 vs. placebo). At follow-up, there were no differences in intracoronary late lumen loss, expressed as neointima volume per mm of stent (1.6 mm 3±1.2 [G-CSF group] vs. 1.9 mm3 ±1.3 [placebo group]; p=0.38), and in minimal instent lumen area (5.4 mm2 ±2.4 vs. 5.3 mm2±2.6, p=0.90). In the placebo group, plasma concentration of stromal cell-derived factor-1 (SDF-1) increased significantly after STEMI. This SDF-1 response was completely suppressed during G-CSF treatment. A rebound increase of SDF-1 was observed after withdrawal of G-CSF (p=0.001). Plasma concentration of SDF-1 at the time of stent implantation correlated positively to neointimal hyperplasia (p=0.025). Conclusions: G-CSF treatment, initiated after PCI, does not lead to excessive instent neointimal hyperplasia or restenosis in patients with STEMI. The timing of G-CSF, in relation to the PCI, might be important, as G-CSF influences SDF-1.

AB - Background: Recombinant granulocyte-colony stimulating factor (G-CSF) mobilized pluripotent cells from the bone marrow are proposed to have a regenerative potential. Though, a report of excessive instent restenosis, in patients treated with G-CSF before percutaneous coronary intervention (PCI) warrants caution. Methods: Patients (n=59) enrolled in the STEMMI trial, a randomized and double blind study, comparing G-CSF and placebo after large ST-elevation myocardial infarctions, had an intracoronary ultrasound imaging at 6 months follow-up with a quantitative analysis of instent neointimal hyperplasia. Results: During G-CSF treatment leukocyte counts, and CD34+ and CD45-/CD34- cell fractions in peripheral blood increased markedly (p<0.0001 vs. placebo). At follow-up, there were no differences in intracoronary late lumen loss, expressed as neointima volume per mm of stent (1.6 mm 3±1.2 [G-CSF group] vs. 1.9 mm3 ±1.3 [placebo group]; p=0.38), and in minimal instent lumen area (5.4 mm2 ±2.4 vs. 5.3 mm2±2.6, p=0.90). In the placebo group, plasma concentration of stromal cell-derived factor-1 (SDF-1) increased significantly after STEMI. This SDF-1 response was completely suppressed during G-CSF treatment. A rebound increase of SDF-1 was observed after withdrawal of G-CSF (p=0.001). Plasma concentration of SDF-1 at the time of stent implantation correlated positively to neointimal hyperplasia (p=0.025). Conclusions: G-CSF treatment, initiated after PCI, does not lead to excessive instent neointimal hyperplasia or restenosis in patients with STEMI. The timing of G-CSF, in relation to the PCI, might be important, as G-CSF influences SDF-1.

KW - Aged

KW - Angioplasty, Balloon, Coronary

KW - Double-Blind Method

KW - Female

KW - Follow-Up Studies

KW - Granulocyte Colony-Stimulating Factor

KW - Hematopoietic Stem Cell Mobilization

KW - Humans

KW - Hyperplasia

KW - Male

KW - Mesenchymal Stromal Cells

KW - Middle Aged

KW - Myocardial Infarction

KW - Neointima

KW - Prospective Studies

KW - Recombinant Proteins

KW - Stents

KW - Treatment Outcome

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DO - 10.1016/j.ijcard.2008.10.029

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C2 - 19056135

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