Journal
CARDIOVASCULAR RESEARCH
Volume 98, Issue 1, Pages 7-27Publisher
OXFORD UNIV PRESS
DOI: 10.1093/cvr/cvt004
Keywords
Cardioprotection: Ischaemia; Reperfusion; Acute myocardial infarction; Cardiac surgery
Categories
Funding
- British Heart Foundation [FS/06/023]
- Department of Health's NIHR Biomedical Research Centres funding scheme
- MRC [MR/K002066/1] Funding Source: UKRI
- British Heart Foundation [RG/08/015/26411] Funding Source: researchfish
- Medical Research Council [MR/K002066/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0510-10164] Funding Source: researchfish
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Coronary heart disease (CHD) is the leading cause of death and disability worldwide. Despite current therapy, the morbidity and mortality for patients with CHD remains significant. The most important manifestations of CHD arise from acute myocardial ischaemiareperfusion injury (IRI) in terms of cardiomyocyte death and its long-term consequences. As such, new therapeutic interventions are required to protect the heart against the detrimental effects of acute IRI and improve clinical outcomes. Although a large number of cardioprotective therapies discovered in pre-clinical studies have been investigated in CHD patients, few have been translated into the clinical setting, and a significant number of these have failed to show any benefit in terms of reduced myocardial infarction and improved clinical outcomes. Because of this, there is currently no effective therapy for protecting the heart against the detrimental effects of acute IRI in patients with CHD. One major factor for this lack of success in translating cardioprotective therapies into the clinical setting can be attributed to problems with the clinical study design. Many of these clinical studies have not taken into consideration the important data provided from previously published pre-clinical and clinical studies. The overall aim of this ESC Working Group Cellular Biology of the Heart Position Paper is to provide recommendations for optimizing the design of clinical cardioprotection studies, which should hopefully result in new and effective therapeutic interventions for the future benefit of CHD patients.
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