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  • Granulocyte colony-stimulating factor therapy for cardiac repair after acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials
  • Abdel-Latif A; Bolli R; Zuba-Surma EK; Tleyjeh IM; Hornung CA; Dawn B
  • Am Heart J 2008[Aug]; 156 (2): 216-226.e9
  • BACKGROUND: Small clinical studies of granulocyte colony-stimulating factor (G-CSF) therapy for cardiac repair after acute myocardial infarction (MI) have yielded divergent results. The effect of G-CSF therapy on left ventricular (LV) function and structure in these patients remains unclear. METHODS: We searched MEDLINE, EMBASE, Science Citation Index, CINAHL, and the Cochrane CENTRAL database of controlled clinical trials (July 2007) for randomized controlled trials of G-CSF therapy in patients with acute MI. We conducted a fixed-effects meta-analysis across 8 eligible studies (n = 385 patients). RESULTS: Compared with controls, G-CSF therapy increased LV ejection fraction (EF) by 1.09%, increased LV scar size by 0.22%, decreased LV end-diastolic volume by 4.26 mL, and decreased LV end-systolic volume by 2.50 mL. None of these effects were statistically significant. The risk of death, recurrent MI, and in-stent restenosis was similar in G-CSF-treated patients and controls. Subgroup analysis revealed a modest but statistically significant increase in EF (4.73%, P < .0001) with G-CSF therapy in studies that enrolled patients with mean EF <50% at baseline. Subgroup analysis also showed a significant increase in EF (4.65%, P < .0001) when G-CSF was administered relatively early (< or =37 hours) after the acute event. CONCLUSIONS: Granulocyte colony-stimulating factor therapy in unselected patients with acute MI appears safe but does not provide an overall benefit. Subgroup analyses suggest that G-CSF therapy may be salutary in acute MI patients with LV dysfunction and when started early. Larger randomized studies may be conducted to evaluate the potential benefits of early G-CSF therapy in acute MI patients with LV dysfunction.
  • |Granulocyte Colony-Stimulating Factor/administration & dosage/*therapeutic use[MESH]
  • |Humans[MESH]
  • |Myocardial Infarction/*drug therapy/mortality/physiopathology[MESH]
  • |Randomized Controlled Trials as Topic[MESH]
  • |Recurrence[MESH]
  • |Stroke Volume/drug effects[MESH]
  • |Ventricular Dysfunction, Left/drug therapy/etiology[MESH]
  • |Ventricular Remodeling/drug effects[MESH]





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    *<b>[http://www.kidney.de/mlpefetch.php?search=18657649 Granulocyte colony-stimulating factor therapy for cardiac repair after acute myocardial infarction: a systematic review and meta-analysis of randomized controlled trials ]</b> Am Heart J 2008; 156(2) ; 216-226.e9 Abdel-Latif A; Bolli R; Zuba-Surma EK; Tleyjeh IM; Hornung CA; Dawn B

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    Am Heart J

    216 2.156 2008