title: Evolving therapies for myocardial ischemia/reperfusion injury.
abstract: The damage inflicted on the myocardium during acute myocardial infarction is the result of 2 processes: ischemia and subsequent reperfusion (ischemia/reperfusion injury). During the last 3 decades, therapies to reduce ischemic injury (mainly reperfusion strategies) have been widely incorporated into clinical practice. The remarkable reduction in death rates achieved with these therapies has resulted in a shift in emphasis from efforts to reduce mortality to a focus on tackling the downstream consequence of survival: post-infarction heart failure. Infarct size is the main determinant of long-term mortality and chronic heart failure, and thus, the possibility of limiting the extent of necrosis during an ST-segment elevation myocardial infarction is of great individual and socioeconomic value. After the great success of therapies to reduce ischemic injury, the time has come to focus efforts on therapies to reduce reperfusion injury, but in the recent few years, few interventions have successfully passed the proof-of-concept stage. In this review, we examine the past, present, and future therapies to reduce ischemia/reperfusion injury.
authors: Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain; Hospital Clínico San Carlos, Madrid, Spain. Electronic address: bibanez@cnic.es.
authors: Borja
authors: B
authors: Ibáñez
authors: Institute for Pathophysiology, West German Heart and Vascular Center, University School of Medicine Essen, Essen, Germany.
authors: Gerd
authors: G
authors: Heusch
authors: Service d'Explorations Fonctionnelles Cardiovasculaires, Centre d'Investigation Clinique de Lyon (CIC) and UMR1060 (CarMeN), Hôpital Louis Pradel, Hospices Civils de Lyon, Lyon, France.
authors: Michel
authors: M
authors: Ovize
authors: Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors: Frans
authors: F
authors: Van de Werf
mesh_terms: D000818:Animals; D052216:Glucagon-Like Peptide 1 / Q000008:administration & dosage; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods / Q000639:trends*; D015425:Myocardial Reperfusion / Q000379:methods / Q000639:trends*; D015428:Myocardial Reperfusion Injury / Q000453:epidemiology / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000639:trends
chemical_list: D052216:Glucagon-Like Peptide 1
keywords: STEMI; ischemia/reperfusion; myocardial infarction; therapy