期刊
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 73, 期 1, 页码 89-99出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2018.09.086
关键词
cardioprotection; ischemia; myocardial infarction; reperfusion
资金
- COST (European Cooperation in Science and Technology)
- National Institute for Health Research University College London Hospitals Biomedical Research Centre
- National Research, Development and Innovation Office of Hungary [NVKP_16-1-2016-0017, OTKA KH 125570, OTKA 115378]
- Higher Education Institutional Excellence Programme of the Ministry of Human Capacities in Hungary, within the framework of the Therapeutic Development thematic programme of the Semmelweis University
- Danish Council for Strategic Research [11-108354]
- Novo Nordisk Foundation (Conditioning Based Intervention Strategies-ConBis)
- Trygfonden
- German Research Foundation [SFB 1116, B 08, SFB/CRC 1213/B05]
- OPeRa [ANR-10-IBHU-0004 OPeRa]
- RHU MARVELOUS [ANR-16-RHUS-0009]
- British Heart Foundation [FS/10/039/28270]
- Duke-National University Singapore Medical School
- Singapore Ministry of Health's National Medical Research Council under its Clinician Scientist-Senior Investigator scheme [NMRC/CSA-SI/0011/2017]
- Collaborative Centre Grant scheme [NMRC/CGAug16C006]
- Singapore Ministry of Education Academic Research Fund Tier 2 [MOE2016-T2-2-021]
- Instituto de Salud Carlos III, CIBERCV-Instituto de Salud Carlos III, Spain [CB16/11/00479]
- European Regional Development Fund-FEDER contribution
- [PIE/2013-00047]
- [PI 17/1397]
Many treatments have been identified that confer robust cardioprotection in experimental animal models of acute ischemia and reperfusion injury. However, translation of these cardioprotective therapies into the clinical setting of acute myocardial infarction (AMI) for patient benefit has been disappointing. One important reason might be that AMI is multifactorial, causing cardiomyocyte death via multiple mechanisms, as well as affecting other cell types, including platelets, fibroblasts, endothelial and smooth muscle cells, and immune cells. Many cardioprotective strategies act through common end-effectors and may be suboptimal in patients with comorbidities. In this regard, emerging data suggest that optimal cardioprotection may require the combination of additive or synergistic multitarget therapies. This review will present an overview of the state of cardioprotection today and provide a roadmap for how we might progress towards successful clinical use of cardioprotective therapies following AMI, focusing on the rational combination of judiciously selected, multitarget therapies. This paper emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225. (c) 2019 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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