Unbound MEDLINE

An update on cardioprotection: a review of the latest adjunctive therapies to limit myocardial infarction size in clinical trials.

Abstract

Acute myocardial infarction (AMI) with subsequent left ventricular dysfunction and heart failure continues to be a major cause of morbidity and mortality in the Western world. Rapid advances in the treatment of AMI, mainly through timely reperfusion, have substantially improved outcomes in patients presenting with acute coronary syndrome and particularly ST-segment elevation myocardial infarction. A vast amount of research, both translational and clinical, has been published on various pharmacological and interventional techniques to prevent myocardial cell death during the time of ischemia and subsequent reperfusion. Several methods of cardioprotection have shown the ability to limit myocardial infarction size in clinical trials. Examples of interventional techniques that have proven beneficial are ischemic post-conditioning and remote ischemic per-conditioning, both of which can reduce infarction size. Lowering core body temperature with cold saline infusion and cooling catheters have also been shown to be effective in certain circumstances. The most promising pharmaceutical cardioprotective agents at this time appear to be adenosine, atrial natriuretic peptide, and cyclosporine, with other potentially effective medications in the pipeline. Additional pre-clinical and clinical research is needed to further investigate newer cardioprotective strategies to continue the current trend of improving outcomes following AMI.

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  • Publisher Full Text
  • Authors

    Gerczuk PZ, Kloner RA

    Institution

    Heart Institute, Good Samaritan Hospital, Wilshire Boulevard, Los Angeles, CA 90017, USA.

    Source

    Journal of the American College of Cardiology 59:11 2012 Mar 13 pg 969-78

    MeSH

    Adenosine
    Adrenergic beta-Antagonists
    Atrial Natriuretic Factor
    Cardiotonic Agents
    Chemotherapy, Adjuvant
    Clinical Trials as Topic
    Coronary Vessels
    Humans
    Ischemic Postconditioning
    Myocardial Infarction
    Reperfusion Injury

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    22402067