Granulocyte colony-stimulating factor attenuates left ventricular remodelling after acute anterior STEMI: Results of the single-blind, randomized, placebo-controlled multicentre STem cEll Mobilization in Acute Myocardial Infarction (STEM-AMI) Trial

Felice Achilli, Cristina Malafronte, Laura Lenatti, Francesco Gentile, Viola Dadone, Giuseppe Gibelli, Stefano Maggiolini, Lidia Squadroni, Claudio Di Leo, Ilaria Burba, Maurizio Pesce, Luca Mircoli, Maurizio C. Capogrossi, Alessandro Di Lelio, Paola Camisasca, Alberto Morabito, Gualtiero Colombo, Giulio Pompilio

Research output: Contribution to journalArticle

Abstract

AimsThe aim of this study was to assess the effect of granulocyte colony-stimulating factor (G-CSF) on left ventricular (LV) function and volumes in patients with anterior ST-elevation myocardial infarction (STEMI) and depressed LV ejection fraction (EF).Methods and resultsSixty consecutive patients with anterior STEMI, undergoing primary angioplasty percutaneous coronary intervention (PCI), with symptom-to-reperfusion time of 2-12 h and EF ≤45 after PCI, were randomized to G-CSF 5 g/kg b.i.d. subcutaneously (n = 24) or placebo (n = 25) for 5 days, starting 99mTechnetium Sestamibi single-photon emission computed tomography (SPECT). Left ventricular EDV and end-systolic volume (ESV) increased from baseline to 6 months in the placebo group (81.7 ± 24.4 to 94.4 ± 26.0 mL/m 2, P <0.00005 and 45.2 ± 20.0 to 53.2 ± 23.8 mL/m 2, P = 0.016) but were unchanged in the G-CSF group (82.2 ± 20.3 to 85.7 ± 23.7 mL/m 2, P = 0.40 and 46.0 ± 18.2 to 48.4 ± 20.8 mL/m 2, P = 0.338). There were no significant differences in EF or perfusion between groups. A significant reduction in transmural LGE segments was seen at 6 months in the G-CSF vs. placebo groups (4.38 ± 2.9 to 3.3 ± 2.6, P = 0.04 and 4.2 ± 2.6 to 3.6 ± 2.7, P = 0.301, respectively). Significantly more placebo patients had a change in left ventricular end-diastolic volume abovethe median (9.3 mL/m 2) when reperfusion time exceeded 180 min (median time-to-reperfusion) (P = 0.0123). Severe adverse events were similar between groups.ConclusionEarly G-CSF administration attenuates ventricular remodelling in patients with anterior STEMI and EF ≤45 after successful PCI.

Original languageEnglish
Pages (from-to)1111-1121
Number of pages11
JournalEuropean Journal of Heart Failure
Volume12
Issue number10
DOIs
Publication statusPublished - Oct 2010

Keywords

  • G-CSF
  • Myocardial infarction
  • Stem cells
  • Ventricular remodelling

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Achilli, F., Malafronte, C., Lenatti, L., Gentile, F., Dadone, V., Gibelli, G., Maggiolini, S., Squadroni, L., Di Leo, C., Burba, I., Pesce, M., Mircoli, L., Capogrossi, M. C., Di Lelio, A., Camisasca, P., Morabito, A., Colombo, G., & Pompilio, G. (2010). Granulocyte colony-stimulating factor attenuates left ventricular remodelling after acute anterior STEMI: Results of the single-blind, randomized, placebo-controlled multicentre STem cEll Mobilization in Acute Myocardial Infarction (STEM-AMI) Trial. European Journal of Heart Failure, 12(10), 1111-1121. https://doi.org/10.1093/eurjhf/hfq150