Summary
Treatment with granulocyte-colony stimulating factor (G-CSF) mobilises cells from
the bone marrow to the peripheral blood. Previous preclinical and early clinical trials
may suggest that treatment with G-CSF leads to improved myocardial perfusion and function
in acute or chronic ischaemic heart disease. In the REVIVAL-2 study we found that
stem cell mobilisation by G-CSF does not influence infarct size, left ventricular
function and coronary restenosis in patients with acute myocardial infarction (MI)
that underwent successful percutaneous coronary intervention. The objective of the
present analysis was to assess the impact of G-CSF treatment on seven-year clinical
outcomes from the REVIVAL-2 trial. In the randomized, double-blind, placebo-controlled
REVIVAL-2 study, 114 patients with the diagnosis of acute myocardial infarction were
enrolled five days after successful reperfusion by percutaneous coronary intervention.
Patients were assigned to receive 10 μg/kg G-CSF (n=56) or placebo (n=58) for five
days. The primary endpoint for this long-term outcome analysis was the composite of
death, myocardial infarction or stroke seven years after randomisation. The endpoint
occurred in 14.3% of patients in the G-CSF group versus 17.2%> assigned to placebo
(p=0.67). The combined incidence of death or myocardial infarction occurred in 14.3%>
of the patients assigned to G-CSF and 15.5%> of the patients assigned to placebo (p=0.85).
In conclusion, these long-term follow-up data show that G-CSF does not improve clinical
outcomes of patients with acute myocardial infarction.
Keywords
Clinical studies - acute myocardial infarction - cardiology - granulocyte-colony stimulating
factor - stem cells
