Reperfusion injury in humans: A review of clinical trials on reperfusion injury inhibitory strategies

医学 临床试验 心肌梗塞 再灌注损伤 再灌注治疗 冠状动脉闭塞 缺血 心脏病学 内科学
作者
Maurits T. Dirksen,Gerrit J. Laarman,M. L. Simoons,D DUNCKER
出处
期刊:Cardiovascular Research [Oxford University Press]
卷期号:74 (3): 343-355 被引量:181
标识
DOI:10.1016/j.cardiores.2007.01.014
摘要

The principal therapy in patients with myocardial infarction to limit infarct size is myocardial reperfusion by mechanical or pharmacological intervention. Reperfusion has been proposed to cause myocardial injury beyond that caused by the preceding ischaemia, termed "reperfusion injury" (RI). While the precise mechanism of RI is still incompletely understood, a large number of clinical studies have been performed over the past decade targeting some of the postulated mechanisms of RI. These clinical studies were based on experimental data demonstrating significant myocardial salvage. Nevertheless, clinical benefits were absent or very limited. The purpose of this review is to provide an overview of the various strategies that inhibit RI and to discuss potential mechanisms that may contribute to the discrepancy between the promising pre-clinical data and the rather disappointing results obtained from prospective clinical trials. There are numerous differences between the experimental models and clinical studies, including the fact that experimental studies typically use abrupt occlusion and reperfusion protocols in animals with previously healthy myocardium that apparently do not predict the therapeutic efficacy of novel cardioprotective agents in a clinical setting with pre-existing progressive coronary disease, intermittent coronary occlusion, and relatively late reperfusion. However, discrepancies also exist between experimental studies. Future experimental studies of reperfusion injury should use models that mimic the clinical situation more closely. Furthermore, future large clinical trials should only be performed in cases where the drug under investigation proved to reduce RI in a series of well-designed (possibly multicenter) experimental studies and in clinical trials with predefined subgroups.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
学者风范完成签到 ,获得积分10
1秒前
进退须臾完成签到,获得积分10
2秒前
图图发布了新的文献求助10
2秒前
liujinjin完成签到,获得积分10
3秒前
甜甜醉波完成签到,获得积分10
3秒前
小不完成签到 ,获得积分10
4秒前
小心薛了你完成签到,获得积分10
10秒前
与离完成签到 ,获得积分10
10秒前
感性的俊驰完成签到 ,获得积分10
14秒前
疯狂的凡梦完成签到 ,获得积分10
15秒前
桥豆麻袋完成签到,获得积分10
16秒前
量子星尘发布了新的文献求助10
17秒前
Hello应助幸福的杨小夕采纳,获得10
17秒前
Lighten完成签到 ,获得积分10
18秒前
lyj完成签到 ,获得积分10
19秒前
成就茗完成签到 ,获得积分10
21秒前
ZD完成签到 ,获得积分10
30秒前
32秒前
英姑应助普鲁卡因采纳,获得10
35秒前
冰糕发布了新的文献求助10
37秒前
BettyNie完成签到 ,获得积分10
39秒前
优雅的平安完成签到 ,获得积分10
39秒前
冰糕完成签到,获得积分10
44秒前
46秒前
852应助完犊子采纳,获得10
50秒前
ruochenzu发布了新的文献求助10
51秒前
不想洗碗完成签到 ,获得积分10
53秒前
const完成签到,获得积分10
57秒前
hjx完成签到 ,获得积分10
57秒前
稳重的尔安完成签到,获得积分10
59秒前
量子星尘发布了新的文献求助10
1分钟前
缓慢的饼干完成签到 ,获得积分10
1分钟前
saturn完成签到 ,获得积分10
1分钟前
金桔希子完成签到,获得积分10
1分钟前
Breeze完成签到 ,获得积分10
1分钟前
1分钟前
昏睡的眼神完成签到 ,获得积分10
1分钟前
文心同学完成签到,获得积分0
1分钟前
demom完成签到 ,获得积分10
1分钟前
duckspy完成签到 ,获得积分10
1分钟前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038112
求助须知:如何正确求助?哪些是违规求助? 3575788
关于积分的说明 11373801
捐赠科研通 3305604
什么是DOI,文献DOI怎么找? 1819255
邀请新用户注册赠送积分活动 892655
科研通“疑难数据库(出版商)”最低求助积分说明 815022