Nitric oxide synthase inhibitors in post-myocardial infarction cardiogenic shock--an update.
Cardiogenic shock (CS) in acute myocardial infarction, after successful coronary angioplasty, still carries a case fatality rate of 50%. These patients succumb to a systemic metabolic storm, superimposed on extensive myocardial necrosis and stunning. Nitric oxide (NO) overproduction contributes to the pathophysiology of this morbid state. Current data regarding the physiologic effects of NO and nitric oxide synthase (NOS) inhibitors on the cardiovascular system are reviewed. Clinical trials assessing the safety and efficacy of NOS inhibitors in CS are summarized.
Kaluski
Edo
E
Department of Cardiology, Assaf Harofeh Medical Center, Zrifin, Israel. ekaluski@gmail.com
Hendler
Alberto
A
Blatt
Alex
A
Uriel
Nir
N
D000208:Acute Disease; D015906:Angioplasty, Balloon, Coronary; D004791:Enzyme Inhibitors / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000201:enzymology / Q000628:therapy; D009204:Myocardial Revascularization; D019331:NG-Nitroarginine Methyl Ester / Q000627:therapeutic use*; D009569:Nitric Oxide / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000037:antagonists & inhibitors* / Q000187:drug effects; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000209:etiology
D004791:Enzyme Inhibitors; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase; D019331:NG-Nitroarginine Methyl Ester