Timing of granulocyte-colony stimulating factor treatment after acute myocardial infarction and recovery of left ventricular function: results from the STEMMI trial

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 -