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January 1, 2014World Journal of CardiologyOpen Access

Several pharmacological therapeutic strategies show promise in initial proof-of-principle clinical studies for reducing the severity of myocardial reperfusion injury in acute myocardial infarction.

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Population

Patients with an acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary…

Design

Review

Key result

Several pharmacological therapeutic strategies show promise in initial proof-of-principle clinical studies for reducing the severity of myocardial reperfusion injury in acute myocardial infarction.

Authors

ADAlberto Domínguez‐RodríguezUniversidad de La Laguna

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Overview

Should not alter STEMI reperfusion practice; hypothesis-generating and requires large RCTs for confirmation.

Key Points

  • To review the pathophysiological mechanisms of myocardial ischemia-reperfusion injury and evaluate potential pharmacological therapies aimed at limiting infarct size and improving clinical outcomes during acute myocardial infarction.
  • Narrative review synthesizing mechanisms of tissue damage occurring during myocardial ischemia and sudden reperfusion.
  • Evaluation of proof-of-concept clinical trials investigating candidate cardioprotective pharmacological agents administered during primary percutaneous coronary intervention.
  • Rapid restoration of blood flow via percutaneous coronary intervention paradoxically induces secondary damage known as ischemia-reperfusion injury, contributing to infarct size and post-infarction heart failure.
  • Promising pharmacological agents—including cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol, and melatonin—demonstrate potential for attenuating reperfusion-induced myocardial injury in early clinical studies.

Structured PICO

P
Population
Patients with an acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
I
Intervention
Pharmacological therapeutic strategies (cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol and melatonin)

This review summarizes the pathophysiology of myocardial ischemia-reperfusion injury and highlights promising pharmacological interventions to mitigate it during primary PCI for STEMI.

Cite This Study

Alberto Domínguez‐Rodríguez (2014) conducted a review in Acute ST-segment elevation myocardial infarction. Pharmacological therapies (e.g., cyclosporin-A, exenatide, glucose-insulin-potassium, atrial natriuretic peptide, adenosine, abciximab, erythropoietin, metoprolol, melatonin) was evaluated. Several pharmacological therapeutic strategies show promise in initial proof-of-principle clinical studies for reducing the severity of myocardial reperfusion injury in acute myocardial infarction.

synapsesocial.com/papers/6a86dff1b712452940cb9ec6https://doi.org/10.4330/wjc.v6.i3.100
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Adenosine as an adjunct to thrombolytic therapy for acute myocardial infarction1999 · 550 citations
  2. 2Heart Disease and Stroke Statistics—2012 Update2011 · 7,240 citations
  3. 3Neutrophil accumulation in ischemic canine myocardium. Insights into time course, distribution, and mechanism of localization during early reperfusion.1991 · 298 citations
  4. 4Myocardial release of malondialdehyde and purine compounds during coronary bypass surgery.1994 · 119 citations
  5. 5Current State of Clinical Translation of Cardioprotective Agents for Acute Myocardial Infarction2013 · 154 citations