Stem Cell Mobilization by G-CSF by Granulocyte Colony Stimulating Factor Post Myocardial Infarction to Promote Myocyte Repair
Inclusion Criteria:
1. Large anterior wall ST elevation AMI defined by: Post AMI LVEF less than 45% as
assessed by echocardiography. It is standard practice at our institution to obtain
echocardiograms on such patients before day 4 post AMI.
2. Age between 40 -75 years
3. Angiographically patent infarct related artery (IRA) with TIMI 3 flow with no
significant stenosis (>70% diameter stenosis in non-intervened upon arteries or >30%
in arteries that had PTCA), no dissection or visible thrombus, and considered at low
risk for re-occlusion by the Cardiologist performing the coronary angiography. In
patients who have undergone PTCA, this assessment will be none on a post PTCA
angiogram. This will be the majority of patients.
4. Eligible for treatment with G-CSF within the 5 days Post AMI.
Exclusion Criteria:
1. Prior STEMI
2. Patients with regional wall motion abnormalities in the non-infarct region
3. Prior CABG or need for CABG
4. Patients with significant valve disease; defined as stenosis or regurgitation graded
as greater than moderate (2+).
5. Patients with clinically apparent, concurrent infection, requiring intravenous
antibiotics
6. Patients who are or could be pregnant
7. Patients with another etiology of LV dysfunction (known/suspected non ischemic
cardiomyopathy, previous anthracycline therapy, known ethanol abuse (greater than 6
oz. ethanol/day on a regular basis).