Endothelial progenitor cells (EPCs) may promote neovascularization in patients with coronary artery disease (CAD). Mobilized EPCs by granulocyte colony-stimulating factor (G-CSF) might increase the exercise duration and improve exercise-induced ST depression in patients with chronic CAD.Methods
Granulocyte colony-stimulating factor (G-CSF), 2.5 mg/kg/day for five days, was administered to 10 patients with CAD. Ischemia was assessed by treadmill exercise testing. The effects of G-CSF on blood were measured by auto hematology analyzer and semi-auto chemistry analyzer.Results
Granulocyte colony-stimulating factor increased the white blood cells (x103/ml) in the circulation from 7.0 ± 0.7 to 19.5 ± 2.2 (p < 0.001). Indices of platelets, hemoglobin, alanine aminotransferase, lactic dehydrogenase, and uric acid were not changed by treatment. The exercise duration after 1 month increased from 4.2 ± 0.49 to 5.8 ± 0.71 (p < 0.005) and disappearance of exercise-induced ST depression compared with baseline. Three patients reported mild myalgia which were easily managed with acetoaminophen.Conclusions
The findings show that granulocyte colony-stimulating factor mobilizes stem cells from bone marrow in patients with coronary artery disease and improve treadmill exercise testing. The therapeutic strategy was safe and tolerable in patients with CAD.