Safety and efficacy of granulocyte colony-stimulating factor for patients with recent myocardial infarction: A meta-analysis

Controversies exist in stem cells mobilization by granulocyte colony-stimulating factor (G-CSF) treating myocardial infarction (MI). A meta-analysis, which included five primary randomized, controlled trials across 326 patients of G-CSF as adjunctive therapy to the standard therapy versus the standard therapy in patients with recent MI, was conducted. Compared with the standard therapy, the addition of G-CSF was associated with (1) a lower risk of target-vessel restenosis and cumulative cardiovascular events (but no statistical significance); (2) a significant improvement of left ventricular ejection fraction in patients with mean age < 55 years (P < 0.00001) but not in the elderly (mean age ≥ 55 years) (P = 0.18). Considering heterogeneity in designs of studies included and inconsistency in the results of the pooled analysis and the sensitivity analysis for LVEF, however, the evidence of a beneficial effect of G-CSF on LVEF in patients mean age < 55 years is weak. Thus, this form of treatment for patients with recent MI may be safe but not superior to the standard therapy and should not be used as a routine arm before enough evidences presented.