Abstract 4357313: Granulocyte Colony Stimulating Factor Therapy for Acute Myocardial Infarction: An Updated Systematic Review and Meta-Analysis

Abstract

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.