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In Reply: Drs Schäbitz and colleagues are concerned that the design of the REVIVAL-2 trial with administration of 10 µg/kg per day of G-CSF starting 5 days after AMI was appropriate to investigate stem cell mobilization effect but not the recently described cytoprotective effect of G-CSF.^1-2 They believe that the investigation of the latter effect would have required a shorter time window from AMI and a higher G-CSF dose.

The objective of the REVIVAL-2 trial was to assess the value of stem cell mobilization by G-CSF in patients with AMI. The rationale for the starting time of the G-CSF treatment after AMI was based on clinical data showing that stem cell mobilization occurs naturally in patients with AMI, peaking at day 7.^3-4 Moreover, the results of the Reinfusion of Enriched Progenitor Cells and Infarct Remodeling in Acute Myocardial Infarction (REPAIR-AMI) trial⁵ show that improvement of left ventricular function is expected . . . [Full Text of this Article]

Dietlind Zohlnhöfer, MD; Ilka Ott, MD; Adnan Kastrati, MD; Albert Schömig, MD
aschoemig@dhm.mhn.de
Deutsches Herzzentrum
Munich, Germany

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