Effect of granulocyte colony-stimulating factor treatment at a low dose but for a long duration in patients with coronary heart disease

Koji Suzuki, Kenshi Nagashima, Masazumi Arai, Yoshihiro Uno, Yu Misao, Genzou Takemura, Kazuhiko Nishigaki, Shinya Minatoguchi, Sachiro Watanabe, Chuwa Tei, Hisayoshi Fujiwara
Circulation Journal: Official Journal of the Japanese Circulation Society 2006, 70 (4): 430-7

BACKGROUND: In animal models, granulocyte colony-stimulating factor (G-CSF) improves post-infarct cardiac function. However, in pilot studies involving patients with angina and acute myocardial infarction (AMI), G-CSF at a high dose frequently induced coronary occlusion or restenosis, but those at a low dose showed no significant beneficial effect. We hypothesized that a low dose but long duration of G-CSF will have a beneficial effect without serious complications to patients with coronary heart disease.

METHODS AND RESULTS: Forty-six patients with angina or AMI were randomly assigned into G-CSF and non-G-CSF control groups, respectively. Recombinant G-CSF was subcutaneously injected once a day for 10 days. The leukocyte counts in the peripheral blood were controlled at approximately 30,000/microl. One month later, a Thallium-201 single photon emission computed tomography revealed the increased percentage uptake and the reduced extent and severity scores in the G-CSF angina group. In the G-CSF AMI group, the curve between the ejection fraction and peak creatine kinase shifted significantly upward, compared with that of the non-G-CSF AMI group. Serious complications were not observed during the 6 months of observation.

CONCLUSIONS: A low dose but long duration of G-CSF treatment may have a beneficial effect without any serious complications in patients with coronary heart disease.

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