Document Detail


Novel adjunctive treatments of myocardial infarction.
MedLine Citation:
PMID:  24976915     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
Myocardial infarction is a major cause of death and disability worldwide and myocardial infarct size is a major determinant of prognosis. Early and successful restoration of myocardial reperfusion following an ischemic event is the most effective strategy to reduce final infarct size and improve clinical outcome, but reperfusion may induce further myocardial damage itself. Development of adjunctive therapies to limit myocardial reperfusion injury beyond opening of the coronary artery gains increasing attention. A vast number of experimental studies have shown cardioprotective effects of ischemic and pharmacological conditioning, but despite decades of research, the translation into clinical effects has been challenging. Recently published clinical studies, however, prompt optimism as novel techniques allow for improved clinical applicability. Cyclosporine A, the GLP-1 analogue exenatide and rapid cooling by endovascular infusion of cold saline all reduce infarct size and may confer clinical benefit for patients admitted with acute myocardial infarcts. Equally promising, three follow-up studies of the effect of remote ischemic conditioning (RIC) show clinical prognostic benefit in patients undergoing coronary surgery and percutaneous coronary intervention. The discovery that RIC can be performed noninvasively using a blood pressure cuff on the upper arm to induce brief episodes of limb ischemia and reperfusion has facilitated the translation of RIC into the clinical arena. This review focus on novel advances in adjunctive therapies in relation to acute and elective coronary procedures.
Authors:
Michael Rahbek Schmidt; Kasper Pryds; Hans Erik Bøtker
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  World journal of cardiology     Volume:  6     ISSN:  1949-8462     ISO Abbreviation:  World J Cardiol     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-06-30     Completed Date:  2014-06-30     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  101537090     Medline TA:  World J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-43     Citation Subset:  -    
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