Differential effect of intracoronary infusion of mobilized peripheral blood stem cells by granulocyte colony-stimulating factor on left ventricular function and remodeling in patients with acute myocardial infarction versus old myocardial infarction: the MAGIC Cell-3-DES randomized, controlled trial
- Kang, Hyun-Jae; Lee, Hae-Young; Na, Sang-Hoon; Chang, Sung-A; Park, Kyung-Woo; Kim, Hyung-Kwan; Kim, Song-Yi; Chang, Ho-Joon; Lee, Whal; Kang, Won Jun; Koo, Bon-Kwon; Kim, Yong-Jin; Lee, Dong Soo; Sohn, Dae-Won; Han, Kyou-Sup; Oh, Byung-Hee; Park, Young-Bae; Kim, Hyo-Soo
- Issue Date
- American Heart Association
- Circulation. 2006 Jul 4;114(1 Suppl):I145-51.
- Acute Disease; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Coronary Restenosis/*prevention & control; Coronary Vessels; Drug Implants; Echocardiography, Doppler, Color; Female; Granulocyte Colony-Stimulating Factor/pharmacology; Hematopoietic Stem Cell Mobilization; Humans; Hyperplasia; Injections, Intra-Arterial; Magnetic Resonance Imaging; Magnetic Resonance Imaging, Cine; Male; Middle Aged; Myocardial Infarction/pathology/*surgery; Peripheral Blood Stem Cell Transplantation/*methods; Stents; Stroke Volume; Transplantation, Autologous; Treatment Outcome; Tunica Intima/pathology; *Ventricular Function, Left; *Ventricular Remodeling
- BACKGROUND: The efficacy of intracoronary infusion of granulocyte colony-stimulating factor (G-CSF) mobilized peripheral blood stem cells (PBSCs) has not been compared between patients with acute (AMI) versus old myocardial infarction (OMI). In addition, the potential risk of restenosis associated with G-CSF-based stem cell therapy has not been evaluated in the setting of drug eluting stent (DES) implantation. METHODS AND RESULTS: We randomly allocated 96 patients with myocardial infarction who underwent coronary revascularization with DES for the culprit lesion into 4 groups. Eighty-two patients completed 6-month follow-up; AMI cell infusion (n=25), AMI control (n=25), OMI cell infusion (n=16), and OMI control group (n=16). In cell infusion groups, PBSCs were mobilized by G-CSF for 3 days and delivered to infarcted myocardium via intracoronary infusion. The AMI cell infusion group showed a significant additive improvement in left ventricular ejection fraction (LVEF) and remodeling compared with controls (change of LVEF: +5.1+/-9.1% versus -0.2+/-8.6%, P<0.05; change of end-systolic volume: -5.4+/-17.0 mL versus 6.5+/-21.9 mL, P<0.05). In OMI patients, however, there was no significant change of LVEF and ventricular remodeling in spite of significant improvement of coronary flow reserve after cell infusion. G-CSF-based cell therapy did not aggravate neointimal growth with DES implantation. CONCLUSIONS: Intracoronary infusion of mobilized PBSCs with G-CSF improves LVEF and remodeling in patients with AMI but is less definite in patients with OMI. G-CSF-based stem cell therapy with DES implantation is both feasible and safe, eliminating any potential for restenosis.
- 1524-4539 (Electronic)