title: Clinical efforts to reduce myocardial infarct size--the next step.
abstract: Prompt myocardial reperfusion reduces infarct size in patients experiencing coronary occlusion. However, its clinical value is limited because reperfusion also causes ischemic myocardial reperfusion injury (IMRI). Considerable research to reduce IMRI has been conducted. Three interventions appear to be promising: 1) myocardial conditioning, which consists of repetitive occlusions of coronary or other arteries prior to or at the time of myocardial reperfusion; 2) the administration of cyclosporine A; and 3) the administration of adenosine. A plan for the testing of these interventions in patients with acute myocardial infarction is described.
authors.affiliation: The TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. ebraunwald@partners.org
authors.forename: Eugene
authors.initials: E
authors.lastname: Braunwald
mesh_terms: D000241:Adenosine / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use; D017408:Guidelines as Topic; D006801:Humans; D057775:Ischemic Postconditioning / Q000379:methods*; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D009203:Myocardial Infarction / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D014665:Vasodilator Agents / Q000627:therapeutic use
chemical_list: D002316:Cardiotonic Agents; D014665:Vasodilator Agents; D016572:Cyclosporine; D000241:Adenosine