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Acute coronary syndromes
Cardiovascular events and re-stenosis following administration of G-CSF in acute myocardial infarction: systematic review and meta-analysis
  1. H Ince1,
  2. M Valgimigli2,
  3. M Petzsch1,
  4. J Suarez de Lezo4,
  5. F Kuethe5,
  6. S Dunkelmann1,
  7. G Biondi-Zoccai3,
  8. C A Nienaber1
  1. 1
    Department of Medicine, Divisions of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Rostock, Germany
  2. 2
    University of Ferrara Cardiovascular Institute in Ferrara, Italy
  3. 3
    Division of Cardiology, University of Turin, Turin, Italy
  4. 4
    University Hospital Reina Sofía, Spain
  5. 5
    Department of Internal Medicine, University Hospital Jena, Germany
  1. Dr Christoph A Nienaber, Division of Cardiology, University Hospital Rostock, Rostock School of Medicine, Ernst-Heydemann-Strasse 6, 18057 Rostock, Germany; christoph.nienaber{at}med.uni-rostock.de

Abstract

Background: Because of the recently published results of the MAGIC study there is confusion as to whether administration of granulocyte-colony stimulating factor (G-CSF) after acute myocardial infarction (MI) should be regarded as a potentially harmful treatment. This meta-analysis of appropriate clinical studies is intended to show the impact of G-CSF given after MI on aggravated incidence of coronary re-stenosis or progression of coronary lesions.

Methods: We used a fixed effects model based on the Mantel-Haenszel method to combine results from the different trials. These studies provided the basis for the current analysis comprising 106 patients of whom 62 were subjected to G-CSF treatment.

Results: Minimum lumen diameter (MLD) measured immediately after percutaneous coronary intervention (PCI) was similar in both groups with a diameter stenosis of 12.3% (SD 9.5%) in the G-CSF group and 10.3% (8.5%) in the control group (p = 0.32). At follow-up, both MLD and percentage stenosis were not different between G-CSF-treated and control patients. Subsequently, averaged late lumen loss revealed similar results and no differences between groups (p = 0.11), and neither stent thrombosis nor re-infarction in either group.

Conclusions: The current meta-analysis of clinical reports fails to justify an elevated risk for coronary re-stenosis after PCI in acute MI or adverse events following G-CSF in the setting of MI when used after state of the art treatment in carefully conducted clinical protocols.

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Footnotes

  • Competing interests: None declared.

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