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Clinical Trial

Evaluation of the Cardioprotective Effect of Granulocyte Colony Stimulating Factor in Patients with Carbon Monoxide Poisoning

Author(s): Atena Pourtaji, Amirhossein Sahebkar, Hoorak Poorzand, Mohammad Moshiri, Amir Hooshang Mohammadpour* and Seyed Reza Mousavi*

Volume 28, Issue 5, 2021

Published on: 22 October, 2020

Page: [589 - 601] Pages: 13

DOI: 10.2174/0929866527666201022112810

Price: $65

Abstract

Background: Carbon monoxide (CO), which is well known as silent killer, has many toxic effects on organs with high rate of metabolism such as heart and brain. CO-induced cardiotoxicity resulted in a wide range of disabilities including electrocardiogram (ECG) abnormalities, elevation in level of cardiac enzymes, arrhythmias, impairment of left ventricular and myocardial infarction (MI). Cardio-protective effects of Granulocyte colony-stimulating factor (G-CSF) on infarcted heart was proved previously in various reports.

Objective: In this study, possible effect of G-CSF on cardiac function of patients with moderate to severe acute CO poisoning was investigated.

Methods: Cardioprotective effects of G-CSF in CO-poisoned patients was evaluated through ECG, Holter monitoring, echocardiography, and biochemical studies. Continuous intravenous infusion of G-CSF (90 μg/kg) and normal saline were administered respectively to treatment and placebo groups.

Results: The results demonstrated that in moderate to severe CO poisoning, myocardial injury is common. ECG changes (e.g., ST-segment and T-wave changes, QTC), cardiac arrhythmias (e.g., heart blocks and ventricular arrhythmias), serum level of Troponin I, left ventricular ejection fraction were determined after G-CSF administration. Frequencies of ST depression, inversion or flatting of T wave and QTC in ECG were significantly reduced after G-CSF treatment. In addition, incidence of cardiac arrhythmias due to CO poisoning were reduced after G-CSF treatment. However, G-CSF did not exert protective effects on TPI level and function of left ventricular in CO-poisoned patients.

Conclusion: GCSF could probably reduce CO-induced cardiac ischemia in patients with acute CO poisoning.

Clinical Trial Registration: The trial protocol was registered in the Iranian Registry of Clinical Trials (http://www.irct.ir) registry (Irct ID: IRCT201607232083N7).

Keywords: Carbon monoxide poisoning, G-CSF, cardiac ischemia, myocardial infarction, arrhythmias, cardiotoxicity.

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