Title:Evaluation of the Cardioprotective Effect of Granulocyte Colony Stimulating Factor in Patients with Carbon Monoxide Poisoning
Volume: 28
Issue: 5
Author(s): Atena Pourtaji, Amirhossein Sahebkar, Hoorak Poorzand, Mohammad Moshiri, Amir Hooshang Mohammadpour* Seyed Reza Mousavi*
Affiliation:
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad,Iran
- Medical Toxicology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad,Iran
Keywords:
Carbon monoxide poisoning, G-CSF, cardiac ischemia, myocardial infarction, arrhythmias, cardiotoxicity.
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).
