Abstract 14901: Granulocyte-colony Stimulating Factor Attenuates Endothelial Dysfunction After Sirolimus-eluting Stent Implantation
Introduction: Endothelial dysfunction after sirolimus-eluting stent (SES) implantation that may be associated with adverse cardiac events during follow-up has been demonstrated. In a rabbit model, enhancement of endothelial healing after paclitaxel-eluting stent implantation by granulocyte-colony stimulating factor (G-CSF) has been reported.
Hypothesis: We assessed the hypothesis that G-CSF attenuates endothelial dysfunction after SES implantation.
Methods: The present double-blinded randomized placebo-control study included 100 patients who underwent SES implantation. They were assigned to the G-CSF group (n=50) or the placebo group (n=50). After successful SES implantation, patients received subcutaneous injection of G-CSF (300 μ g daily) or saline for 5 days. Endothelial function was estimated by measuring the coronary vasoreactivity in reference segment within 15 mm proximal and distal to SES in response to intracoronary acetylcholine infusion (10-8 and 10-7 mol/L) at 9-month follow-up. Endothelium-independent vasomotion was assessed after an intracoronary bolus of isosorbide dinitrate.
Results: Follow-up angiography was performed in 41 patients (82%) at 292.0 ± 22.6 days for the G-CSF group and 46 patients (92%) at 287.0 ± 10.3 days for the placebo group (p = 0.14 and p = 0.18, respectively). Changes in coronary diameter in response to acetylcholine infusion in segment proximal to SES were not significantly different between the 2 groups. However, in segment distal to SES, vasoconstriction to acetylcholine infusion was attenuated in the G-CSF group (Figure).
Conclusion: In conclusion, G-CSF attenuates endothelial dysfunction after SES implantation.
- © 2011 by American Heart Association, Inc.