Emerging drugs for acute myocardial infarction.
BACKGROUND
The present review is aimed at going over the pharmacological profile (and the clinical impact) of the emerging drugs involved in the management of patients with ST-elevation myocardial infarction (STEMI) in order to provide the cardiologists who deal with these patients in the early phase with the most recent evidence on this topic.


METHODS
Anticoagulant and antiplatelet drugs are the main cornerstones of therapy in the treatment of STEMI patients undergoing primary percutaneous coronary intervention (PCI). The main issues that clinicians have to deal with are represented by balancing thrombotic and bleeding risks. In tailoring therapy, variables such as age, sex and previous disease should be taken into account, as well as ongoing complications (such as acute renal failure) that could affect hemostasis. Despite the well-established clinical benefits of antiplatelet agents, questions remain, mainly surrounding potential for variable platelet response, which are strictly related to non-genetic (i.e., diet, drug-drug interaction, clinical factors such as obesity, diabetes mellitus, and inflammation) and genetic determinants.


RESULTS
In their daily practice, cardiologists cannot abstract from the knowledge and updating on the ongoing research fields as well as the newly developed drugs, which they should frame in the very patient in the attempt to the develop a personalized medical strategy. These include also the pharmacological option(s) in the treatment of the reperfusion injury, the metabolic aspects and the stem cell therapy. TAKE HOME MASSAGE: In our opinion, the goal of ongoing research on the pharmacological approach to STEMI patients is a personalized medical strategy that relies on critical clinicians who merge newly developed acquisitions on this topic and a more complete, systemic and critical approach to the patient.
Lazzeri
Chiara
C
University of Florence, Department of Heart and Vessels, Florence, Italy.
Tarquini
Roberto
R
Valente
Serafina
S
Abbate
Rosanna
R
Gensini
G F
GF
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D000818:Animals; D017147:Defibrillators, Implantable; D016503:Drug Delivery Systems / Q000379:methods; D015507:Drugs, Investigational / Q000627:therapeutic use*; D006401:Hematologic Agents / Q000627:therapeutic use*; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000628:therapy; D054318:No-Reflow Phenomenon / Q000517:prevention & control; D015427:Reperfusion Injury / Q000188:drug therapy*; D012770:Shock, Cardiogenic / Q000188:drug therapy* / Q000628:therapy; D033581:Stem Cell Transplantation / Q000706:statistics & numerical data; D014665:Vasodilator Agents / Q000627:therapeutic use*
D015507:Drugs, Investigational; D006401:Hematologic Agents; D014665:Vasodilator Agents