Document Detail

Effects of granulocyte-colony-stimulating factor on mobilization of bone-marrow-derived stem cells after myocardial infarction in humans.
MedLine Citation:
PMID:  16501636     Owner:  NLM     Status:  MEDLINE    
Recent experimental studies have shown that granulocyte-colony-stimulating factor (G-CSF) enhanced cardiac function after infarction. The concept of direct cytokine or cell-mediated effects on postischemic myocardial function was tested in the setting of human myocardial infarction subjected to percutaneous coronary intervention. In the FIRSTLINE-AMI study 50 consecutive patients with first ST-elevation myocardial infarction were randomly assigned to receive either 10 microg/kg G-CSF for 6 days after percutaneous coronary intervention in addition to standard medication, or standard care alone. G-CSF administration led to mobilization of CD34(+) mononuclear stem cells (MNC(CD34+)), with a 20-fold increase to 64 +/- 37 MNC(CD34+)/microl at day 6 without significant associated changes in rheology, blood viscosity or inflammatory reaction, or any major adverse effects. At 4 months the G-CSF group showed improved left ventricular ejection fraction of 54 +/- 8% versus 48 +/- 4% at baseline (P <0.001), and no evidence of left ventricular end-diastolic remodeling, with a diameter of 55 +/- 5 mm and improved segmental wall thickening (P <0.001); conversely, in control patients left ventricular ejection fraction was 43 +/- 5% at 4 months (P <0.001), with increased left ventricular end-diastolic dimension of 58 +/- 4 mm (P <0.001), and no segmental wall thickening. In conclusion, the FIRSTLINE-AMI study showed that G-CSF administration and mobilization of MNC(CD34+) after reperfusion of infarcted myocardium may offer a pragmatic strategy for preservation of human myocardium and prevention of remodeling without evidence of aggravated atherosclerosis.
Christoph A Nienaber; Michael Petzsch; Hans Dieter Kleine; Heike Eckard; Matthias Freund; Hüseyin Ince
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Nature clinical practice. Cardiovascular medicine     Volume:  3 Suppl 1     ISSN:  1743-4297     ISO Abbreviation:  Nat Clin Pract Cardiovasc Med     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-27     Completed Date:  2006-11-08     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  101226507     Medline TA:  Nat Clin Pract Cardiovasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  S73-7     Citation Subset:  IM    
Department of Cardiology, Rostock University Hospital, Rostock School of Medicine, Rostock, Germany.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / therapeutic use
Bone Marrow Cells / drug effects*
Cell Movement*
Granulocyte Colony-Stimulating Factor / pharmacology*,  therapeutic use
Immunoglobulin Fab Fragments / therapeutic use
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology,  therapy
Platelet Aggregation Inhibitors / therapeutic use
Treatment Outcome
Ventricular Function, Left / drug effects
Ventricular Remodeling / drug effects
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 143011-72-7/Granulocyte Colony-Stimulating Factor; X85G7936GV/abciximab

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