PT  - JOURNAL ARTICLE
AU  - Toyama, Takuji
AU  - Hoshizaki, Hiroshi
AU  - Kan, Hakuken
AU  - Kawaguchi, Ren
AU  - Adachi, Hitoshi
AU  - Ohsima, Shigeru
AU  - Kurabayashi, Masahiko
TI  - Is the granulocyte colony-stimulating factor therapy in the earliest phase effective to rescue patients with acute myocardial infarction?
DP  - 2014 May 01
TA  - Journal of Nuclear Medicine
PG  - 239--239
VI  - 55
IP  - supplement 1
4099  - http://jnm.snmjournals.org/content/55/supplement_1/239.short
4100  - http://jnm.snmjournals.org/content/55/supplement_1/239.full
SO  - J Nucl Med2014 May 01; 55
AB  - 239 Objectives Granulocyte colony-stimulating factor (G-CSF) was reported to induce myocardial regeneration and vascularization by mobilization of bone marrow stem cells and reduce apoptosis of endothelial cells after acute myocardial infarction(AMI). Meta-analysis showed improvement in LVEF in early G-CSF therapy. But there were no reports G-CSF therapy was started during reperfusion therapy. This study purpose is to clarify whether the earliest start of G-CSF can get beneficial effects. Methods Forty consecutive patients(M/F=31/9,age=65±9y)with initial ST elevation AMI randomly assigned to receive G-CSF (2μg/kg) therapy (G-CSF group:G) or saline(control group:C) for 5 days. First administration was during PCI. Nuclear examinations, cardiopulmonary exercise-testing were done on subacute(SA) and 6 months(M) periods. The summed defect score(TDS) of perfusion MIBI and fatty acid metabolism BMIPP imagings on 17 SPECT segments and LVEF,EDV,ESV and regional wall motion(RWM) of AMI segments were estimated. The restenosis rate, target lesion revascularization(TLR) rate and adverse cardiac events(MACE) were also evaluated for 1 year. Results There were no significant differences in basic characteristics, EDV(SA), AT and peak VO2 in both periods, restenosis rate, TLR rate and MACE between two groups. As compared to the control group, the G-CSF group demonstrated a greater reduction in MIBI-TDS(6M) (G:5.9±7.3 vs. C:13.1±10.8), BMIPP-TDS(SA) (G:15.3±10.5 vs. C:22.7±9.5), BMIPP-TDS(6M)(G:10.2±8.9 vs. C:16.8±9.0), ESV(SA)(G:54±28ml vs. C:76±40ml), ESV(6M)(G:45±24ml vs. C:65±35ml) and a greater increase in EF(SA)(G:54±11% vs. C:45±13%), EF(6M)(G:59±10% vs. C:51±11%), RWM(SA)(G:1.8±1.5 vs. C:1.4±1.4), RWM(6M)(G:3.0±1.5 vs. C:2.4±1.6). Conclusions The earliest start of G-CSF therapy in AMI patients can improve myocardial perfusion, fatty acid metabolism and cardiac function in subacute and follow-up periods.