Author + information
- Received May 10, 2011
- Revision received June 13, 2011
- Accepted July 19, 2011
- Published online March 13, 2012.
- ↵⁎Reprint requests and correspondence:
Dr. Robert A. Kloner, Heart Institute, Good Samaritan Hospital, 1225 Wilshire Boulevard, Los Angeles, California 90017
Acute myocardial infarction (AMI) with subsequent left ventricular dysfunction and heart failure continues to be a major cause of morbidity and mortality in the Western world. Rapid advances in the treatment of AMI, mainly through timely reperfusion, have substantially improved outcomes in patients presenting with acute coronary syndrome and particularly ST-segment elevation myocardial infarction. A vast amount of research, both translational and clinical, has been published on various pharmacological and interventional techniques to prevent myocardial cell death during the time of ischemia and subsequent reperfusion. Several methods of cardioprotection have shown the ability to limit myocardial infarction size in clinical trials. Examples of interventional techniques that have proven beneficial are ischemic post-conditioning and remote ischemic per-conditioning, both of which can reduce infarction size. Lowering core body temperature with cold saline infusion and cooling catheters have also been shown to be effective in certain circumstances. The most promising pharmaceutical cardioprotective agents at this time appear to be adenosine, atrial natriuretic peptide, and cyclosporine, with other potentially effective medications in the pipeline. Additional pre-clinical and clinical research is needed to further investigate newer cardioprotective strategies to continue the current trend of improving outcomes following AMI.
- limit infarct size
- myocardial infarction
- remote conditioning
The authors have reported that they have no relationships relevant to the contents of this paper to disclose in regards to the clinical trials discussed. Dr. Kloner's laboratory receives grants for pre-clinical studies on cardioprotection from Stealth Peptides and Gilead. Dr. Kloner is a consultant to Stealth and a speaker for Gilead.
- Received May 10, 2011.
- Revision received June 13, 2011.
- Accepted July 19, 2011.
- American College of Cardiology Foundation