Cardiovascular events and re-stenosis following administration of G-CSF in acute myocardial infarction: systematic review and meta-analysis.
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.
Ince
H
H
Department of Medicine, Divisions of Cardiology at the University Hospital Rostock, Rostock School of Medicine, Rostock, Germany.
Valgimigli
M
M
Petzsch
M
M
de Lezo
J Suarez
JS
Kuethe
F
F
Dunkelmann
S
S
Biondi-Zoccai
G
G
Nienaber
C A
CA
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D006332:Cardiomegaly / Q000209:etiology* / Q000473:pathology; D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000209:etiology*; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology*; D003627:Data Interpretation, Statistical; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D016179:Granulocyte Colony-Stimulating Factor