Effects of stem cell mobilization by granulocyte colony-stimulating factor on endothelial function after sirolimus-eluting stent implantation: A double-blind, randomized, placebo-controlled clinical trial

Background Stem 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. Methods One 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. Results Follow-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 −7 mol/L (−8.8% ± 11.0% vs −15.2% ± 7.6%, P Conclusion Granulocyte colony-stimulating factor attenuates endothelial dysfunction after SES implantation.