PMID- 34279451
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210722
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 10
IP  - 13
DP  - 2021 Jul 1
TI  - Reducing Cardiac Injury during ST-Elevation Myocardial Infarction: A Reasoned 
      Approach to a Multitarget Therapeutic Strategy.
LID - 10.3390/jcm10132968 [doi]
LID - 2968
AB  - The significant reduction in 'ischemic time' through capillary diffusion of 
      primary percutaneous intervention (pPCI) has rendered myocardial-ischemia 
      reperfusion injury (MIRI) prevention a major issue in order to improve the 
      prognosis of ST elevation myocardial infarction (STEMI) patients. In fact, while 
      the ischemic damage increases with the severity and the duration of blood flow 
      reduction, reperfusion injury reaches its maximum with a moderate amount of 
      ischemic injury. MIRI leads to the development of post-STEMI left ventricular 
      remodeling (post-STEMI LVR), thereby increasing the risk of arrhythmias and heart 
      failure. Single pharmacological and mechanical interventions have shown some 
      benefits, but have not satisfactorily reduced mortality. Therefore, a multitarget 
      therapeutic strategy is needed, but no univocal indications have come from the 
      clinical trials performed so far. On the basis of the results of the consistent 
      clinical studies analyzed in this review, we try to design a randomized clinical 
      trial aimed at evaluating the effects of a reasoned multitarget therapeutic 
      strategy on the prevention of post-STEMI LVR. In fact, we believe that the 
      correct timing of pharmacological and mechanical intervention application, 
      according to their specific ability to interfere with survival pathways, may 
      significantly reduce the incidence of post-STEMI LVR and thus improve patient 
      prognosis.
FAU - Bellis, Alessandro
AU  - Bellis A
AUID- ORCID: 0000-0003-3476-5696
AD  - Unita Operativa Complessa Cardiologia con UTIC ed Emodinamica-Dipartimento 
      Emergenza Accettazione, Azienda Ospedaliera "Antonio Cardarelli", Via A. 
      Cardarelli n. 9, 80131 Napoli, Italy.
FAU - Di Gioia, Giuseppe
AU  - Di Gioia G
AUID- ORCID: 0000-0003-3297-8399
AD  - Cardiac Catheterization Laboratory, Montevergine Clinic, Via M. Malzoni, 83013 
      Mercogliano, Italy.
FAU - Mauro, Ciro
AU  - Mauro C
AD  - Unita Operativa Complessa Cardiologia con UTIC ed Emodinamica-Dipartimento 
      Emergenza Accettazione, Azienda Ospedaliera "Antonio Cardarelli", Via A. 
      Cardarelli n. 9, 80131 Napoli, Italy.
FAU - Mancusi, Costantino
AU  - Mancusi C
AUID- ORCID: 0000-0001-6690-1408
AD  - Dipartimento di Scienze Biomediche Avanzate, Universita FEDERICO II, Via S. 
      Pansini n. 5, 80131 Napoli, Italy.
FAU - Barbato, Emanuele
AU  - Barbato E
AD  - Dipartimento di Scienze Biomediche Avanzate, Universita FEDERICO II, Via S. 
      Pansini n. 5, 80131 Napoli, Italy.
AD  - Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium.
FAU - Izzo, Raffaele
AU  - Izzo R
AD  - Dipartimento di Scienze Biomediche Avanzate, Universita FEDERICO II, Via S. 
      Pansini n. 5, 80131 Napoli, Italy.
FAU - Trimarco, Bruno
AU  - Trimarco B
AUID- ORCID: 0000-0002-0701-6449
AD  - Dipartimento di Scienze Biomediche Avanzate, Universita FEDERICO II, Via S. 
      Pansini n. 5, 80131 Napoli, Italy.
FAU - Morisco, Carmine
AU  - Morisco C
AUID- ORCID: 0000-0002-2158-6317
AD  - Dipartimento di Scienze Biomediche Avanzate, Universita FEDERICO II, Via S. 
      Pansini n. 5, 80131 Napoli, Italy.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210701
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC8268641
OTO - NOTNLM
OT  - coronary microvascular obstruction
OT  - extracellular matrix
OT  - left ventricular remodeling
OT  - primary percutaneous coronary intervention
OT  - remote ischemic conditioning
COIS- The authors declare no conflict of interest.
EDAT- 2021/07/20 06:00
MHDA- 2021/07/20 06:01
PMCR- 2021/07/01
CRDT- 2021/07/19 12:52
PHST- 2021/05/27 00:00 [received]
PHST- 2021/06/22 00:00 [revised]
PHST- 2021/06/27 00:00 [accepted]
PHST- 2021/07/19 12:52 [entrez]
PHST- 2021/07/20 06:00 [pubmed]
PHST- 2021/07/20 06:01 [medline]
PHST- 2021/07/01 00:00 [pmc-release]
AID - jcm10132968 [pii]
AID - jcm-10-02968 [pii]
AID - 10.3390/jcm10132968 [doi]
PST - epublish
SO  - J Clin Med. 2021 Jul 1;10(13):2968. doi: 10.3390/jcm10132968.