Late Reperfusion of A Totally Occluded Infarct-Related Artery Increases Granulocyte-Colony Stimulation Factor and Reduces Stroma-Derived Factor-1.ALPHA. Blood Levels in Patients With Ongoing Ischemia After Acute Myocardial Infarction

Abstract

SummaryAfter acute myocardial infarction (AMI), reopening of a totally occluded infarct-related artery (IRA) at a subacute stage is still controversial in symptom-free patients. However, in patients with persistent ischemic symptoms and inadequate collaterals to the infarct area, recanalization is thought to provide beneficial effects. In addition to augmenting myocardial perfusion, we hypothesized that the benefit of recanalization involves the manipulation of circulating stem cell-mobilizing cytokines. This study included 30 patients with a totally occluded IRA and ongoing ischemic symptoms (the study group) and 30 patients with a partially occluded IRA (the control group). All patients underwent successful angioplasty and/or stenting. Before and immediately after the coronary intervention, blood granulocyte-colony-stimulating factor (G-CSF), stem-cell factor (SCF), vascular endothelial growth factor (VEGF), and stroma-derived factor-1 (SDF-1α) were measured. After recanalization, G-CSF levels significantly increased in the study group compared to the control group (P = 0.03). SDF-1α levels in the study group decreased relative to the controls (P = 0.02). However, no significant changes in VEGF or SCF levels between the two groups were found. In the multivariate analysis, reopening of a totally occluded IRA was independently and significantly associated with changes in G-CSF and SDF-1α levels after recanalization. In conclusion, our data suggest that the benefits of late reperfusion of a totally occluded IRA in patients with ongoing myocardial ischemia may involve mechanisms associated with stem cell-mobilizing and plaque-stabilizing cytokines. This study provides the rationale to investigate serial changes in cytokines and the numbers of circulating progenitors after reperfusion in the future. (Int Heart J 2009; 50: 433-444)

A Long-Term Follow-Up Study of Intravenous Autologous Mesenchymal Stem Cell Transplantation in Patients With Ischemic Stroke

“…Moreover, SDF‐1α/CXC chemokine receptor‐4 (CXCR4) axis mediated the migration of neural progenitor cells after stroke [32]. Circulating SDF‐1α may be sequestered within the vessel wall or infarcted area in patients with myocardial infarct or ischemic stroke [33], which may increase the local concentration of SDF‐1α. These findings suggest that the SDF‐1α level of early‐stage stroke play an important role in functional recovery after MSC treatment.…”