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Translating Cardioprotective Strategies into Clinical Settings

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Book cover Management of Myocardial Reperfusion Injury

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Abstract

The major objective of the treatment of ST elevation myocardial infarction (STEMI) patients is to reduce infarct size, which is the major prognostic factor in this population. Most of the progress has consisted in improving reperfusion therapy, both by opening as quickly as possible and by preventing reocclusion of the culprit coronary artery. Basic science research used in well-described animal models allowed to clearly establish the major determinants of infarct size, i.e., area at risk, collateral flow, duration of ischemia, and timing of the protective intervention with respect to reflow. Recent reports have proven that lethal reperfusion injury exists, that it is of significant importance, and that it can be prevented by protective interventions applied immediately before reflow. Therefore, after taking care of the vessel, it is now time to better protect the muscle against lethal reperfusion injury. In spite of several past negative infarct size reduction studies, recent proof-of-concept studies have shown that infarct size reduction is possible in STEMI patients, at least in part because the major determinants of infarct size have been taken into account. Increased understanding of underlying mechanisms from animal models together with encouraging results from phase II infarct size reduction clinical trials should help us improve the design of future studies aimed at reducing infarct size in STEMI patients.

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Author information

Authors and Affiliations

  1. Department of Cardiology and Clinical Research, Inserm U 1060 (CARMEN), Lyon, France

    Nathan Mewton M.D., Ph.D. & Michel Ovize M.D., Ph.D.

  2. Service d’Exploration Fonctionnelles Cardiovasculaires, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Lyon, France

    Nathan Mewton M.D., Ph.D. & Michel Ovize M.D., Ph.D.

  3. Department of Cardiology, Inserm U661, Montpellier, France

    François Roubille M.D., Ph.D. & Christophe Piot M.D., Ph.D.

  4. Hopital Arnaud de Villeneuve, Université de Montpellier I and II, Montpellier, France

    François Roubille M.D., Ph.D. & Christophe Piot M.D., Ph.D.

  5. Department of Cardiology, Service de Cardiologie, Hôpital Rangueuil, University Paul Sabatier, Toulouse, France

    Olivier Lairez M.D., Ph.D. & Meyer Elbaz M.D., Ph.D.

  6. Department of Cardiology, Inserm U 1060 (CARMEN), Lyon, France

    Gilles Rioufol M.D., Ph.D.

  7. Interventional Cardiology, Hospices Civils de Lyon, Université Claude Bernard Lyon1, Lyon, France

    Gilles Rioufol M.D., Ph.D.

  8. Hôpital Louis Pradel, 59 Bd Pinel, 69394, Lyon, France

    Michel Ovize M.D., Ph.D.

  9. University of Lyon, Lyon, France

    Michel Ovize M.D., Ph.D.

Authors
  1. Nathan Mewton M.D., Ph.D.
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  2. François Roubille M.D., Ph.D.
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  3. Olivier Lairez M.D., Ph.D.
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  4. Gilles Rioufol M.D., Ph.D.
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  5. Meyer Elbaz M.D., Ph.D.
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  6. Christophe Piot M.D., Ph.D.
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  7. Michel Ovize M.D., Ph.D.
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Corresponding author

Correspondence to Michel Ovize M.D., Ph.D. .

Editor information

Editors and Affiliations

  1. Medical School, Coronary Artery Disease, Research Group, St George's Hospital, Cranmer Terrace, London, SW17 0RE, United Kingdom

    Juan Carlos Kaski

  2. Hatter Cardiovascular Inst., Div. Medicine, University College London, Chenies Mews 67, London, WC1E 6HX, United Kingdom

    Derek J. Hausenloy

  3. Mayo Graduate School of Medicine, Dept. Cardiovascular Diseases, Mayo Clinic, First Street SW. 200, Rochester, 55905, Minnesota, USA

    Bernard John Gersh

  4. Hatter Cardiovascular Institute, University College London, Chenies Mews 67, London, WC1E 6HX, United Kingdom

    Derek M. Yellon

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© 2012 Springer-Verlag London

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Mewton, N. et al. (2012). Translating Cardioprotective Strategies into Clinical Settings. In: Kaski, J., Hausenloy, D., Gersh, B., Yellon, D. (eds) Management of Myocardial Reperfusion Injury. Springer, London. https://doi.org/10.1007/978-1-84996-019-9_5

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  • DOI: https://doi.org/10.1007/978-1-84996-019-9_5

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-018-2

  • Online ISBN: 978-1-84996-019-9

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