title: The future: therapy of myocardial protection.
abstract: The main determinant of myocardial necrosis following an acute myocardial infarction (AMI) is duration of ischemia. Infarct size is a strong independent predictor of postinfarction mortality. Interventions able to protect the myocardium from death during an AMI (cardioprotection) are urgently needed. Myocardial injury associated with reperfusion (ischemia/reperfusion injury [I/R]) significantly contributes to the final necrotic size. Duration of ischemia can only be reduced by social and emergency medical services--hospital collaborative programs. However, for a given duration of ischemia, infarct size can be limited by reducing reperfusion injury. Despite the fact that several therapies have been shown to reduce I/R injury in animal models, translation to humans has been frustrating. The cost of developing new drugs able to reduce I/R injury is huge, and this is a major roadblock in the field of cardioprotection. Recent studies have proposed that old, inexpensive drugs--in human use for decades (e.g., β-blockers and cyclosporine, among others)--can reduce I/R injury when administered intravenously before coronary opening. The demonstration of such a cardioprotective effect should have a significant impact in the care of AMI patients.
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Sanz-Rosa
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
authors.forename: Jaime
authors.initials: J
authors.lastname: García-Prieto
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.|Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
authors.forename: Borja
authors.initials: B
authors.lastname: Ibanez
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D017130:Angioplasty; D000818:Animals; D002316:Cardiotonic Agents / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D015428:Myocardial Reperfusion Injury / Q000473:pathology / Q000517:prevention & control*; D009336:Necrosis; D013997:Time Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D002316:Cardiotonic Agents