Background Due to 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 infartion (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 restenosis or progression of coronary lesions.
Methods and Results 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. <BR> Minimum lumen diameter (MLD) measured immediately after percutaneous coronary intervention (PCI) was similar in both groups with a diameter stenosis of 12.3±9.5 percent in the G-CSF and 10.3±8.5 percent in the control group (p=0.32). At follow-up, both MLD and percent 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 reinfarction in either group.
Conclusions The current meta-analysis of clinical reports fails to justify an elevated risk for coronary restenosis 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.
- acute myocardial infarction
- stem cells
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