title: Cardioprotection for percutaneous coronary intervention--reperfusion quality as well as quantity.
abstract: Ischaemia-reperfusion (IR) injury is an important cause of myocardial damage during percutaneous coronary intervention (PCI). There are few therapies in widespread clinical use which impact on IR injury and it remains an important and underutilized target for treatment in acute myocardial infarction. This review will examine the translational scientific evidence for ischaemic conditioning and pharmacological agents including conditioning mimetics such as cyclosporine, anti-inflammatory agents, and those which modify myocardial glucose metabolism. We will address the reasons why many trials have failed to demonstrate clinical benefit and emphasize the need to deliver the right therapy to the right patient, at the right time to achieve successful translation of cardioprotection from bench-to-bedside. We critique trial design and offer advice for future translational trials in the field to ensure that effective treatments can be demonstrated clinically to improve patient outcomes during PCI.
authors.affiliation: Department of Interventional Cardiology, Papworth Hospital, Cambridge, UK.
authors.forename: Joel P
authors.initials: JP
authors.lastname: Giblett
authors.affiliation: Department of Interventional Cardiology, Papworth Hospital, Cambridge, UK.
authors.forename: Nick E J
authors.initials: NE
authors.lastname: West
authors.affiliation: Department of Interventional Cardiology, Papworth Hospital, Cambridge, UK. Electronic address: stephen.hoole@papworth.nhs.uk.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hoole
mesh_terms: D000818:Animals; D002316:Cardiotonic Agents / Q000008:administration & dosage*; D006801:Humans; D015425:Myocardial Reperfusion / Q000379:methods*; D015428:Myocardial Reperfusion Injury / Q000175:diagnosis / Q000517:prevention & control*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015398:Signal Transduction / Q000187:drug effects / Q000502:physiology
chemical_list: D002316:Cardiotonic Agents
keywords: Cardioprotection; Ischaemia-reperfusion injury; Ischemic conditioning; Myocardial infarction; Percutaneous coronary intervention