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Table 2 Factors that have been tested to improve collateral circulation

From: The collateral circulation of the heart

Method (references) Positive effecta Application Remarks
Exercise [50], [51] Yes   No randomized data, increase in CFI.
External counterpulsation [47] Yes   One randomized controlled trial (RCT), observational studies, increase in CFI, improvement of angina symptoms
GM-CSF [45, 52] Yes Intracoronary, subcutaneous Two small RCTs (n = 21, n = 12). Stopped early because of potential plaque destabilization. Increase in CFI.
G-CSF [44] Yes Subcutaneous One small randomized trial (n = 52). Increase in CFI.
Dipyridamole [53] Yes   Very small trial (n = 30); angiographic collateral assessment, which is not very accurate
VEGF [54] No Intracoronary No difference in angina symptoms or exercise tolerance
FGF4 (adenovirus) [55] No Intracoronary No change in exercise tolerance
  1. aBased on a random effects meta-analysis model if more than one study.
  2. CFI, collateral flow index; FGF4, fibroblast growth factor 4; G-CSF, granulocyte colony-stimulating factor; GM-CSF, granulocyte-macrophage colony-stimulating factor (GM-CSF); VEGF, vascular endothelial growth factor.