In-stent neo-intimal hyperplasia after stem cell mobilization by granulocyte-colony stimulating factor Preliminary intracoronary ultrasound results from a double-blind randomized placebo-controlled study of patients treated with percutaneous coronary intervention for ST-elevation myocardial infarction (STEMMI Trial).

Abstract

OBJECTIVE:

The influence of treatment with granulocyte-colony stimulating factor (G-CSF) on the development of in-stent intimal hyperplasia is not known. We aimed to study this phenomenon in patients who had stents implanted in the course of an acute ST-elevation infarction and successively were treated with G-CSF.

METHOD:

We performed angiography and intracoronary ultrasound follow-up after 5 months in 41 consecutive patients in the STEMMI trial, which is a randomized double-blind placebo-controlled study on the effect of G-CSF injections on the myocardial function following acute myocardial infarction in patients treated with primary percutaneous coronary stent implantation. The intracoronary ultrasound images were analyzed by a blinded and independent core laboratory.

RESULTS:

There were no differences in in-stent neo-intimal hyperplasia determined by intracoronary ultrasound between patients treated with G-CSF compared to patients treated with placebo. Neo-intimal hyperplasia per mm of stent was 1.87 (+/-1.41) and 1.89 (+/-1.39), respectively (p = 0.97). Angiographic in-segment restenosis (>50% diameter stenosis) was found in 28% of patients (24% in the G-CSF group and 33% in the placebo group; p = 0.55).

CONCLUSION:

G-CSF treatment following coronary stent implantation in primary PCI treated AMI patients does not increase in-stent restenosis excessively and it does not seem warranted to limit further study of effects of G-CSF for that reason.

• Authors: Erik Jørgensen, Rasmus S Ripa, Steffen Helqvist, Yongzhong Wang, Hans Erik Johnsen, Peer Grande, Jens Kastrup
• Journal: International journal of cardiology (Int J Cardiol) Vol. 111 Issue 1 Pg. 174-7 (Jul 28 2006) ISSN: 0167-5273 [Print] Netherlands
• PMID: 16054717 (Publication Type: Letter, Research Support, Non-U.S. Gov't)

Chemical References

• Granulocyte Colony-Stimulating Factor

Topics

• Angioplasty, Balloon, Coronary
• Coronary Restenosis (diagnostic imaging, pathology)
• Double-Blind Method
• Electrocardiography
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Hematopoietic Stem Cell Mobilization
• Humans
• Hyperplasia
• Male
• Middle Aged
• Myocardial Infarction (physiopathology, therapy)
• Randomized Controlled Trials as Topic
• Stents
• Tunica Intima (pathology)
• Ultrasonography