title: Novel therapeutics in myocardial infarction: targeting microvascular dysfunction and reperfusion injury.
abstract: Despite the large number of novel therapies under basic scientific investigation, the translation of cardioprotective strategies targeting reperfusion injury to improve patient outcomes following percutaneous coronary intervention (PCI) for myocardial infarction (MI) has been disappointing. The varying susceptibility of an individual to reperfusion injury, as well as the narrow window of opportunity in which to intervene, adds significant complexity. Here, we discuss the unmet need and challenges of translating cardioprotective strategies into clinical practice, review the pathophysiology of microvascular dysfunction and lethal reperfusion as they relate to promising novel therapeutics, and evaluate recent and ongoing clinical trials in the field.
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA. Electronic address: christopher.fordyce@duke.edu.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Fordyce
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.affiliation: Columbia University Medical Center/New York-Presbyterian Hospital and the Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.affiliation: Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Granger
mesh_terms: D000818:Animals; D002316:Cardiotonic Agents / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008833:Microcirculation; D055806:Microvessels / Q000187:drug effects* / Q000503:physiopathology; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000601:surgery; D015428:Myocardial Reperfusion Injury / Q000188:drug therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*
chemical_list: D002316:Cardiotonic Agents
keywords: coronary microcirculation; myocardial infarction; novel therapeutics; reperfusion injury