Abstract Body (Do not enter title and authors here): Introduction
Granulocyte Colony-Stimulating Factor (G-CSF) has been proposed as a therapeutic strategy for improving cardiac repair after acute myocardial infarction (AMI). A previous meta-analysis of randomized controlled trials (RCTs) evaluated the efficacy and safety of G-CSF but showed no statistically significant improvement. Recently, new studies provided an opportunity to update the current knowledge.
Methods
We searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs comparing G-CSF to placebo or standard of care in AMI patients. The outcomes of interest were Left Ventricular End-Diastolic Volume (LVEDV), Left Ventricular Ejection Fraction (LVEF) and mortality. Eleven RCTs involving 1,073 patients were included.
Results
G-CSF significantly reduced LVEDV in the echocardiography subgroup (MD: -4.39 mL; 95% CI -6.80, -1.98; p < 0.001), while no effect was observed in the MRI subgroup (MD: -0.19 mL; 95% CI -7.22, 6.84; p = 0.958). Similarly, LVEF improved significantly in the echocardiography subgroup (MD: 6.76%; 95% CI 1.62, 11.90; p = 0.010) but not in the MRI subgroup (MD: -0.08%; 95% CI -2.38, 2.22; p = 0.947). No impact was observed on mortality (RR:1.00, 95% CI 0.45, 2.23, p = 0.995).
Conclusion
G-CSF was associated with a reduction in LVEDV and improvement in LVEF in echocardiography studies, suggesting potential structural benefits. However, clinical outcomes remained unchanged. Larger, high-quality trials are needed to better understand the therapeutic role of G-CSF in AMI patients.