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Outcomes and Risks of Granulocyte Colony-Stimulating Factor in Patients With Coronary Artery Disease

Jonathan M. Hill, MD^_*,||,_*, Mushabbar A. Syed, MD^,¶, Andrew E. Arai, MD, Tiffany M. Powell, MD, MPH^_*,#, Jonathan D. Paul, MD^_*,_**, Gloria Zalos, RN^_*, Elizabeth J. Read, MD, Hanh M. Khuu, MD, Susan F. Leitman, MD, McDonald Horne, MD, Gyorgy Csako, MD, Cynthia E. Dunbar, MD, Myron A. Waclawiw, PhD and Richard O. Cannon, III, MD^_*,_*

^_* Cardiovascular Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
Laboratory of Cardiac Energetics, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
Hematology Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
^|| Department of Cardiology, King’s College, London, United Kingdom
^¶ Cardiology Division, Emory University, Atlanta, Georgia
^# Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
^_** University of Chicago Hospitals, Chicago, Illinois
Department of Transfusion Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland
Department of Laboratory Medicine, Clinical Center, National Institutes of Health, Bethesda, Maryland

View larger version (30K): [in a new window]   Figure 1 Hematopoietic progenitor cells normalized to the total mononuclear cell count at baseline and within 24 h of the fifth dose of granulocyte colony-stimulating factor (G-CSF) 10 µg/kg/day in 16 coronary artery disease patients and in 15 control subjects.

View larger version (25K): [in a new window]   Figure 2 Plasma levels of platelet factor-4 (PF4, top panel), thrombin-antithrombin complexes (T-AT, middle panel), and C-reactive protein (CRP, bottom panel) at baseline and at selected days during and following G-CSF administration to 16 CAD patients. There were no differences between PF4 and T-AT values by analysis of variance (p = 0.407 and p = 0.731, respectively). A nonparametric statistic was used for CRP comparisons. Data is mean ± SEM. Abbreviations as in Figure 1.

View larger version (35K): [in a new window]   Figure 3 Treadmill exercise duration (top panel) and systolic blood pressure-heart rate (pressure-rate) product (bottom panel) using the modified Bruce protocol for coronary artery disease patients treated with G-CSF. Mean values are identified by the bar at each time point. There were no differences in values among the time points of exercise testing by analysis of variance (p = 0.479 and p = 0.220, respectively). Abbreviations as in Figure 1.