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G-CSF for Extensive STEMI : Results from the STEM-AMI OUTCOME CMR Substudy

Title: G-CSF for Extensive STEMI : Results from the STEM-AMI OUTCOME CMR Substudy
Authors: Achilli F.; Pontone G.; Bassetti B.; Squadroni L.; Campodonico J.; Corrada E.; Facchini C.; Mircoli L.; Esposito G.; Scarpa D.; Pidello S.; Righetti S.; Di Gennaro F.; Guglielmo M.; Muscogiuri G.; Baggiano A.; Limido A.; Lenatti L.; Di Tano G.; Malafronte C.; Soffici F.; Ceseri M.; Maggiolini S.; Colombo G. I.; Pompilio G.
Contributors: F. Achilli; G. Pontone; B. Bassetti; L. Squadroni; J. Campodonico; E. Corrada; C. Facchini; L. Mircoli; G. Esposito; D. Scarpa; S. Pidello; S. Righetti; F. Di Gennaro; M. Guglielmo; G. Muscogiuri; A. Baggiano; A. Limido; L. Lenatti; G. Di Tano; C. Malafronte; F. Soffici; M. Ceseri; S. Maggiolini; G.I. Colombo; G. Pompilio
Publisher Information: Lippincott Williams and Wilkins
Publication Year: 2019
Collection: The University of Milan: Archivio Istituzionale della Ricerca (AIR)
Subject Terms: granulocyte colony-stimulating factor; left ventricular remodeling; myocardial infarction; percutaneous coronary intervention; standard of care; Settore MED/11 - Malattie dell'Apparato Cardiovascolare; Settore MED/23 - Chirurgia Cardiaca
Description: Rationale: In the exploratory Phase II STEM-AMI (Stem Cells Mobilization in Acute Myocardial Infarction) trial, we reported that early administration of G-CSF (granulocyte colony-stimulating factor), in patients with anterior ST-segment-elevation myocardial infarction and left ventricular (LV) dysfunction after successful percutaneous coronary intervention, had the potential to significantly attenuate LV adverse remodeling in the long-Term. Objective: The STEM-AMI OUTCOME CMR (Stem Cells Mobilization in Acute Myocardial Infarction Outcome Cardiac Magnetic Resonance) Substudy was adequately powered to evaluate, in a population showing LV ejection fraction ≤45% after percutaneous coronary intervention for extensive ST-segment-elevation myocardial infarction, the effects of early administration of G-CSF in terms of LV remodeling and function, infarct size assessed by late gadolinium enhancement, and myocardial strain. Methods and Results: Within the Italian, multicenter, prospective, randomized, Phase III STEM-AMI OUTCOME trial, 161 ST-segment-elevation myocardial infarction patients were enrolled in the CMR Substudy and assigned to standard of care (SOC) plus G-CSF or SOC alone. In 119 patients (61 G-CSF and 58 SOC, respectively), CMR was available at baseline and 6-month follow-up. Paired imaging data were independently analyzed by 2 blinded experts in a core CMR lab. The 2 groups were similar for clinical characteristics, cardiovascular risk factors, and pharmacological treatment, except for a trend towards a larger infarct size and longer symptom-To-balloon time in G-CSF patients. ANCOVA showed that the improvement of LV ejection fraction from baseline to 6 months was 5.1% higher in G-CSF patients versus SOC (P=0.01); concurrently, there was a significant between-group difference of 6.7 mL/m2 in the change of indexed LV end-systolic volume in favor of G-CSF group (P=0.02). Indexed late gadolinium enhancement significantly decreased in G-CSF group only (P=0.04). Moreover, over time improvement of global ...
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/31138020; info:eu-repo/semantics/altIdentifier/wos/WOS:000475949200007; volume:125; issue:3; firstpage:295; lastpage:306; numberofpages:12; journal:CIRCULATION RESEARCH; https://hdl.handle.net/2434/723403
DOI: 10.1161/CIRCRESAHA.118.314617
Availability: https://hdl.handle.net/2434/723403; https://doi.org/10.1161/CIRCRESAHA.118.314617
Rights: info:eu-repo/semantics/openAccess
Accession Number: edsbas.FEC2902C
Database: BASE