Cardioprotection: emerging pharmacotherapy.
By the year 2020, it is predicted that acute coronary occlusion will be the major cause of death in the world. Recent advances in reperfusion therapy have substantially improved survival of patients with acute coronary syndromes. While early reperfusion reduces mortality, a time limitation exists with regard to myocardial salvage. In fact, the major limiting factor in further improving survival of patients with myocardial ischaemia is the susceptibility of the cardiomyocyte to ischaemic insult and lethal cell injury. Over the last decade substantial progress has been made in our understanding of the fundamental mechanisms of ischaemia/reperfusion injury. From this work novel means which limit or delay myocyte death have emerged and are currently under development as therapeutic candidates for the management of acute coronary syndromes. This report examines cardioprotective mechanisms and reviews clinical evidence for myocardial protective therapies.
Gumina
R J
RJ
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and Foundation, 200 First Street SW, Rochester, Minnesota 55905, USA.
Jahangir
A
A
Gross
G J
GJ
Terzic
A
A
D006321:Heart / Q000187:drug effects*; D006801:Humans; D019194:Ischemic Preconditioning; D008274:Magnesium / Q000627:therapeutic use; D017202:Myocardial Ischemia / Q000188:drug therapy*; D015428:Myocardial Reperfusion Injury / Q000517:prevention & control*; D015221:Potassium Channels / Q000187:drug effects; D020011:Protective Agents / Q000627:therapeutic use*; D058906:Purinergic P1 Receptor Agonists; D017923:Sodium-Hydrogen Exchangers / Q000037:antagonists & inhibitors
D015221:Potassium Channels; D020011:Protective Agents; D058906:Purinergic P1 Receptor Agonists; D017923:Sodium-Hydrogen Exchangers; D008274:Magnesium