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

作者：Kang HJ; Lee HY; Na SH; Chang SA; Park KW; Kim HK; Kim SY; Chang HJ; Lee W; Kang WJ; Koo BK; Kim YJ; Lee DS; Sohn DW; Han KS; Oh BH; Park YB; Kim HS^*

来源：Circulation, 2006, 114: I145-I151.

DOI：10.1161/CIRCULATIONAHA.105.001107

• myocardial infarction
• stem cell
• G-CSF

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.

• 出版日期2006-7-4