Novel targets and future strategies for acute cardioprotection: Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart

Cardiovasc Res. 2017 May 1;113(6):564-585. doi: 10.1093/cvr/cvx049.

Abstract

Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic-however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI.

Keywords: Cardioprotection; Ischaemia; Ischaemic conditioning; Myocardial Infarction; Reperfusion.

Publication types

  • Practice Guideline
  • Review

MeSH terms

  • Animals
  • Cardiology / methods*
  • Cardiology / standards
  • Cardiovascular Agents / adverse effects
  • Cardiovascular Agents / therapeutic use*
  • Coronary Artery Bypass / adverse effects*
  • Coronary Artery Bypass / standards
  • Disease Models, Animal
  • Heart Failure / etiology
  • Heart Failure / pathology
  • Heart Failure / physiopathology
  • Heart Failure / prevention & control*
  • Humans
  • Ischemic Postconditioning / methods
  • Ischemic Preconditioning / adverse effects
  • Ischemic Preconditioning / methods*
  • Ischemic Preconditioning / standards
  • Ischemic Preconditioning, Myocardial / methods
  • Myocardial Reperfusion Injury / etiology
  • Myocardial Reperfusion Injury / pathology
  • Myocardial Reperfusion Injury / physiopathology
  • Myocardial Reperfusion Injury / prevention & control*
  • Percutaneous Coronary Intervention / adverse effects*
  • Percutaneous Coronary Intervention / standards
  • Protective Factors
  • Risk Factors
  • ST Elevation Myocardial Infarction / complications
  • ST Elevation Myocardial Infarction / pathology
  • ST Elevation Myocardial Infarction / physiopathology
  • ST Elevation Myocardial Infarction / therapy*
  • Translational Medical Research / methods*
  • Translational Medical Research / standards
  • Treatment Outcome

Substances

  • Cardiovascular Agents