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Cardiovascular events and restenosis following administration of G-CSF in acute myocardial infarction: Systematic Review of the literature and individual patient-data meta-analysis
  1. Hueseyin Ince
  1. University Hospital Rostock, Germany
    1. Marco Valgimigli
    1. Univesity of Ferrera Cardiovascular Institute, Italy
      1. Michael Petzsch
      1. University Hospital Rostock, Germany
        1. Jose Suarez de Lezo
        1. University Hospital Reina Sofia, Spain
          1. Friedhelm Kuethe
          1. University Hospital Jena, Germany
            1. Simone Dunkelmann
            1. University Hospital Rostock, Germany
              1. Giuseppe Biondi-Zoccai
              1. Policlinico San Donato, Italy
                1. Christoph A. Nienaber (christoph.nienaber{at}med.uni-rostock.de)
                1. University Hospital Rostock, Germany

                  Abstract

                  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.

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