[Pharmacological protection against myocardial infarction: realities and actualities].
Coronary heart disease and myocardial infarction remain a major problem of public health with an annual incidence of 120,000 cases in France. Although several techniques of early repermeabilization of the obstructed coronary arteries have been available for almost twenty years with an associated high degree of reduction in morbidity and mortality of post-infarction patients, such success still remains dependent on the delay to the procedure to enable maximal protection of the myocardium against necrosis. Thus, pharmacological "cardioprotection" against ischemic injury must be considered as an additional and complementary opportunity to enhance myocardial survival following acute infarction. On the basis of current knowledge of the pathological, physiological and pharmacological processes involved in pre- and postconditioning, new strategies of cardioprotection associated with reperfusion of the myocardium have been proposed in recent years. The efficacy of these new approaches has been proven pre-clinically using experimental models but their real clinical relevance and their ability to reduce human myocardial infarction-associated morbidity and mortality remains to be determined.
Berdeaux
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Laboratoire de Pharmacologie, Inserm U 841/03, Faculté de médecine de Créteil, 8, rue du Général Sarrail, F 94010 Créteil Cedex. alain.berdeaux@creteil.inserm.fr
D000818:Animals; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D005602:France; D006801:Humans; D009203:Myocardial Infarction / Q000517:prevention & control*; D017202:Myocardial Ischemia / Q000517:prevention & control
D002316:Cardiotonic Agents