title: A review of strategies for infarct size reduction during acute myocardial infarction.
abstract: Advances in medical and interventional therapy over the last few decades have revolutionized the treatment of acute myocardial infarction. Despite the ability to restore epicardial coronary artery patency promptly through percutaneous coronary intervention, tissue level damage may continue. The reported 30-day mortality after all acute coronary syndromes is 2 to 3%, and around 5% following myocardial infarction. Post-infarct complications such as heart failure continue to be a major contributor to cardiovascular morbidity and mortality. Inadequate microvascular reperfusion leads to worse clinical outcomes and potentially strategies to reduce infarct size during periods of ischemia-reperfusion can improve outcomes. Many strategies have been tested, but no single strategy alone has shown a consistent result or benefit in large scale randomised clinical trials. Herein, we review the historical efforts, current strategies, and potential novel concepts that may improve myocardial protection and reduce infarct size.
authors.affiliation: Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada.
authors.forename: Yasir
authors.initials: Y
authors.lastname: Parviz
authors.affiliation: Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: Sethumadhavan
authors.initials: S
authors.lastname: Vijayan
authors.affiliation: Division of Cardiology, London Health Sciences Centre, Western University, London, Ontario, Canada. Electronic address: shahar.lavi@lhsc.on.ca.
authors.forename: Shahar
authors.initials: S
authors.lastname: Lavi
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000628:therapy*; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D009203:Myocardial Infarction / Q000473:pathology* / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D062645:Percutaneous Coronary Intervention / Q000379:methods; D016896:Treatment Outcome
keywords: Infarct size; Myocardial infarction; Reperfusion