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Granulocyte-colony-stimulating factor in acute myocardial infarction: future perspectives after FIRSTLINE-AMI and REVIVAL-2

Nature Clinical Practice Cardiovascular Medicine volume 4, pages S114–S118 (2007)Cite this article

Abstract

Granulocyte-colony-stimulating factor (G-CSF) seems to have direct cardioprotective effects related to mobilization of autologous bone-marrow mononuclear CD34+ cells. These properties have attracted the attention of researchers investigating new therapeutic strategies for acute myocardial infarction. The role of G-CSF in bone-marrow cell mobilization removes the need for bone-marrow aspiration and repeated invasive procedures. This factor, coupled with the fact that G-CSF can be administered by noninvasive subcutaneous injection, give this approach a potential advantage over other cell-therapy options. This article is intended to present a concise overview of the current experimental and clinical findings for G-CSF therapy after acute myocardial infarction. In particular, we discuss the conflicting findings from the front-integrated revascularization and stem cell liberation in evolving acute myocardial infarction (FIRSTLINE-AMI) and the Regenerate Vital Myocardium by Vigorous Activation of Bone Marrow Stem Cells (REVIVAL-2) studies.

Key Points

  • Granulocyte-colony-stimulating factor (G-CSF) seems to have direct cardioprotective effects

  • This growth factor can be administered by subcutaneous injection without the need for bone-marrow aspiration, manipulation of stem cells in culture, or repeated invasive procedures

  • Potential beneficial effects of G-CSF therapy after AMI reported in the FIRSTLINE-AMI study have been challenged by the REVIVAL-2 study, but the two studies had important differences in design

  • An adequately powered, double-blind, randomized, multicenter study is required, without a time delay between percutaneous coronary intervention and G-CSF application

  • Firm prognostic conclusions about G-CSF therapy after percutaneous coronary intervention for ST-segment elevation myocardial infarction cannot yet be drawn

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Authors and Affiliations

  1. H Ince is an interventional cardiologist in the Department of Medicine, and CA Nienaber is Medical Director of the Cardiology Department in the Department of Medicine, Division of Cardiology, at the University Hospital Rostock, Rostock School of Medicine, Rostock, Germany.,

    Hüseyin Ince & Christoph A Nienaber

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  1. Hüseyin Ince
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  2. Christoph A Nienaber
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Correspondence to Hüseyin Ince.

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The authors declare no competing financial interests.

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Ince, H., Nienaber, C. Granulocyte-colony-stimulating factor in acute myocardial infarction: future perspectives after FIRSTLINE-AMI and REVIVAL-2. Nat Rev Cardiol 4 (Suppl 1), S114–S118 (2007). https://doi.org/10.1038/ncpcardio0731

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  • DOI: https://doi.org/10.1038/ncpcardio0731

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