• Yo Iwata, Yoshihide Fujimoto, Tomoki Morino, Kazumasa Sugimoto, Kenji Ohkubo, Tadayuki Kadohira, Kenichi Fukushima, Hideki Kitahara, Issei Komuro, and Yoshio Kobayashi.
• Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
• Am. Heart J. 2013 Mar 1; 165 (3): 408-14.

BackgroundStem cell mobilization by granulocyte colony-stimulating factor (G-CSF) has been shown to enhance endothelial healing after spontaneous or iatrogenic arterial disruption. Granulocyte colony-stimulating factor treatment might attenuate endothelial dysfunction after sirolimus-eluting stent (SES) implantation that may be associated with adverse cardiac events during follow-up. This prospective, double-blind, randomized, placebo-controlled study investigated whether G-CSF improved endothelial dysfunction after SES implantation.MethodsOne hundred patients who underwent SES implantation were randomly assigned to the G-CSF (n = 50) or the placebo group (n = 50). They received daily subcutaneous injection of 300 μg G-CSF or saline for 5 days. Endothelial function was estimated by measuring the coronary vasoreactivity in the segments 15 mm proximal and distal to SES in response to intracoronary infusion of acetylcholine (10(-8) and 10(-7) mol/L) at 9-month follow-up.ResultsFollow-up angiography was performed in 41 G-CSF patients (82%) and 46 placebo patients (92%) (P = .14). Changes in coronary diameter in response to acetylcholine infusion in the proximal segment were not significantly different between the 2 groups. However, vasoconstriction in the distal segment in response to 10(-8) mol/L (-3.9% ± 6.4% vs -7.0% ± 8.1%, P < .05) and 10(-7) mol/L (-8.8% ± 11.0% vs -15.2% ± 7.6%, P < .01) acetylcholine infusion was attenuated in the G-CSF group. Endothelium-independent vasodilatation after nitrate infusion did not differ between the 2 groups.ConclusionGranulocyte colony-stimulating factor attenuates endothelial dysfunction after SES implantation.Copyright © 2013 Mosby, Inc. All rights reserved.

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