Why the study?
Do parenteral treatments to reduce free fatty acid availability improve outcomes in patients with acute coronary syndrome?
Do parenteral treatments to reduce free fatty acid availability improve outcomes in patients with acute coronary syndrome?
Highlights the theoretical need for early parenteral interventions to reduce free fatty acid availability during acute myocardial ischaemia, noting a lack of clinical trials.
Untested strategies to lower free fatty acids in acute ischaemia should not change practice; leaves open whether parenteral interventions improve ACS outcomes.
During the onset of an acute coronary syndrome, an immediate increase in plasma free fatty acid (FFA) concentrations presents the ischaemic underperfused myocardium with a metabolic challenge to its survival. For the maintenance of contraction and to counter ventricular arrhythmias, parenteral treatment to reduce FFA availability should be available for paramedics when the patient is first seen. The best treatment options are insulin which partly inhibits FFA release from adipose tissue, immediate reduction of adipose tissue lipolysis, perhaps by new analogues of nicotinic acid, or measures to decrease the FFA/molar binding ratio with albumin. None has yet been tested in appropriate clinical trials.
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M. F. Oliver (2010) studied this question.
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