Chapter 11 Novel Cardioprotective Strategies
Derek Hausenloy and
Derek Yellon
- • Despite optimal therapy, the mortality and morbidity of coronary heart disease remains significant. Hence, novel treatment strategies of cardioprotection are required to improve clinical outcomes in these patients
- • Experimental studies have provided a plethora of therapeutic strategies for reducing myocardial injury, but the translation of these findings into the clinical setting has been largely disappointing. Many of these unsuccessful clinical studies have relied upon individually targeting established mediators of lethal reperfusion injury such as oxidative stress, inflammation, calcium overload and so forth
- • Clearly, novel targets for cardioprotection as well as a multi-targeted approach to cardioprotection directed against the multiple causes of lethal reperfusion injury are required to effect benefits in clinical outcomes
- • In this regard, the introduction of ischaemic postconditioning, a novel treatment strategy, in which following primary PCI the process of myocardial reperfusion is interrupted by several coronary re-occlusions, has been reported to reduce myocardial myocardial injury in AMI patients
- • Furthermore, experimental studies have identified the Reperfusion Injury Salvage Kinase (RISK) pathway and the mitochondrial permeability transition pore (mPTP) as novel targets for cardioprotection, which are currently been examined in the clinical setting.
