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Updated: May 12, 2026
Intramyocardial Cell Delivery: Observations in Murine Hearts
Published on: January 24, 2014
Stem cell mobilization by granulocyte colony-stimulating factor in patients with acute myocardial infarction: a
Dietlind Zohlnhöfer1, Ilka Ott, Julinda Mehilli
1Deutsches Herzzentrum, Technische Universität München, Munich, Germany.
Insights
Granulocyte colony-stimulating factor (G-CSF) therapy did not improve cardiac function or reduce infarct size in patients with acute myocardial infarction. This stem cell mobilization approach showed no benefit in preventing coronary restenosis.
Area of Science:
- Cardiology
- Regenerative Medicine
- Clinical Trials
Background:
- Experimental studies suggest stem cell transplantation may enhance cardiac repair after myocardial infarction.
- Granulocyte colony-stimulating factor (G-CSF) is known to mobilize bone marrow stem cells.
Purpose of the Study:
- To evaluate the efficacy of G-CSF therapy in mobilizing stem cells for treating acute myocardial infarction.
- To assess G-CSF's impact on infarct size, left ventricular function, and coronary restenosis.
Main Methods:
- A randomized, double-blind, placebo-controlled trial involving patients with ST-segment elevation acute myocardial infarction.
- Patients received either G-CSF (10 microg/kg daily for 5 days) or a placebo subcutaneously.
- Primary endpoint: reduction in left ventricular infarct size; Secondary endpoints: ejection fraction improvement and restenosis incidence.
Main Results:
- G-CSF treatment significantly mobilized stem cells but did not reduce left ventricular infarct size (P = .56).
- No significant improvement in left ventricular ejection fraction was observed compared to placebo (P = .14).
- The incidence of angiographic restenosis was similar between the G-CSF and placebo groups (P = .79).
Conclusions:
- Stem cell mobilization using G-CSF therapy does not influence infarct size in acute myocardial infarction patients.
- G-CSF therapy shows no beneficial effect on left ventricular function or coronary restenosis after myocardial infarction.
- The study did not support the use of G-CSF for stem cell mobilization in this patient population.
Context:
Experimental studies and early phase clinical trials suggest that transplantation of blood-derived or bone marrow-derived stem cells may improve cardiac regeneration and neovascularization after acute myocardial infarction. Granulocyte colony-stimulating factor (G-CSF) induces mobilization of bone marrow stem cells.
Objective:
To assess the value of stem cell mobilization by G-CSF therapy in patients with acute myocardial infarction.
Design, Setting, And Patients:
Randomized, double-blind, placebo-controlled trial of patients diagnosed with ST-segment elevation acute myocardial infarction who had successful reperfusion by percutaneous coronary intervention within 12 hours after onset of symptoms in Germany between February 24, 2004, and February 2, 2005.
Interventions:
Patients were randomly assigned to receive subcutaneously either a daily dose of 10 microg/kg of G-CSF or placebo for 5 days.
Main Outcome Measures:
The primary end point was reduction of left ventricular infarct size according to technetium Tc 99m sestamibi scintigraphy performed at baseline and at 4 to 6 months after randomization. Secondary end points included improvement of left ventricular ejection fraction measured by magnetic resonance imaging and the incidence of angiographic restenosis.
Results:
Of the 114 patients, 56 were assigned to receive treatment with G-CSF and 58 were assigned to receive placebo. Treatment with G-CSF produced a significant mobilization of stem cells. Between baseline and follow-up, left ventricular infarct size according to scintigraphy was reduced by a mean (SD) of 6.2% (9.1%) in the G-CSF group and 4.9% (8.9%) in the placebo group (P = .56) and left ventricular ejection fraction was improved by 0.5% (3.8%) in the G-CSF group and 2.0% (4.9%) in the placebo group (P = .14). Angiographic restenosis occurred in 19 (35.2%) of 54 patients in the G-CSF group and in 17 (30.9%) of 55 patients in the placebo group (P = .79). The most common adverse event among patients assigned to G-CSF was mild to moderate bone pain and muscle discomfort.
Conclusion:
Stem cell mobilization by G-CSF therapy in patients with acute myocardial infarction and successful mechanical reperfusion has no influence on infarct size, left ventricular function, or coronary restenosis.
Clinical Trial Registration:
ClinicalTrials.gov Identifier: NCT00126100.
