Optimising cardioprotection during myocardial ischaemia: targeting potential intracellular pathways with glucagon-like peptide-1

Cardiovasc Diabetol. 2014 Jan 11;13:12. doi: 10.1186/1475-2840-13-12.

Abstract

Coronary heart disease and type-2 diabetes are both major global health burdens associated with an increased risk of myocardial infarction (MI). Following MI, ischaemia-reperfusion injury (IRI) remains a significant contributor to myocardial injury at the cellular level. Research has focussed on identifying a strategy or intervention to minimise IRI to optimise reperfusion therapy, with the aim of delivering a superior clinical outcome. The incretin hormone glucagon-like peptide-1, already an established basis for the treatment of type-2 diabetes, also has the potential to protect against IRI. We explain the physiology and cellular processes involved in IRI, and the intracellular pathways activated by GLP-1, which could intercept IRI and deliver cardioprotection. The review also examines the current preclinical and clinical evidence for GLP-1 in cardioprotection and future directions for research as we look for an effective adjunctive treatment to minimise IRI.

Publication types

  • Review

MeSH terms

  • Animals
  • Cardiotonic Agents / administration & dosage*
  • Drug Delivery Systems / methods*
  • Glucagon-Like Peptide 1 / administration & dosage*
  • Humans
  • Intracellular Fluid / drug effects
  • Intracellular Fluid / metabolism*
  • Myocardial Ischemia / metabolism*
  • Myocardial Ischemia / pathology
  • Myocardial Ischemia / prevention & control*
  • Signal Transduction / drug effects
  • Signal Transduction / physiology

Substances

  • Cardiotonic Agents
  • Glucagon-Like Peptide 1