期刊
BRITISH JOURNAL OF PHARMACOLOGY
卷 177, 期 23, 页码 5252-5269出版社
WILEY
DOI: 10.1111/bph.14839
关键词
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资金
- 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]
- Duke-National University Singapore Medical School, Singapore Ministry of Health's National Medical Research Council under its Collaborative Centre Grant scheme [NMRC/CGAug16C006]
- National Institute for Health Research University College London Hospitals Biomedical Research Centre [CS/14/3/31002]
- Novo Nordisk Foundation [NNF15OC0016674, NNF14OC0013337]
- RHU MARVELOUS [ANR-16-RHUS-0009]
- TrygFonden [109624]
- OPeRa [ANR-10-IBHU-0004 OPeRa]
- Singapore Ministry of Education Academic Research Fund Tier 2 [MOE2016-T2-2-021]
- Singapore Ministry of Health's National Medical Research Council [NMRC/CSA-SI/0011/2017, NMRC/CGAug16C006]
- Duke-National University Singapore Medical School
- British Heart Foundation [CS/14/3/31002]
- Danish Council for Strategic Research [11-108354]
- German Research Foundation [SFB 1116 B08]
- MRC [MC_G1002673] Funding Source: UKRI
The translation of cardioprotection from robust experimental evidence to beneficial clinical outcome for patients suffering acute myocardial infarction or undergoing cardiovascular surgery has been largely disappointing. The present review attempts to critically analyse the evidence for confounders of cardioprotection in patients with acute myocardial infarction and in patients undergoing cardiovascular surgery. One reason that has been proposed to be responsible for such lack of translation is the confounding of cardioprotection by co-morbidities and co-medications. Whereas there is solid experimental evidence for such confounding of cardioprotection by single co-morbidities and co-medications, the clinical evidence from retrospective analyses of the limited number of clinical data is less robust. The best evidence for interference of co-medications is that for platelet inhibitors to recruit cardioprotection per se and thus limit the potential for further protection from myocardial infarction and for propofol anaesthesia to negate the protection from remote ischaemic conditioning in cardiovascular surgery.
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