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Cardioprotection for Acute MI in Light of the CONDI2/ERIC-PPCI Trial: New Targets Needed

Authors
  • Giblett, Joel P1
  • Bulluck, Heerajnarain2
  • 1 Department of Cardiology, Liverpool Heart and Chest Hospital, Liverpool, UK
  • 2 Department of Cardiology, Norfolk and Norwich University Hospital, Norwich, UK
Type
Published Article
Journal
Interventional Cardiology Review
Publisher
Radcliffe Cardiology
Publication Date
Aug 25, 2020
Volume
15
Identifiers
DOI: 10.15420/icr.2020.01
PMID: 32944081
PMCID: PMC7479528
Source
PubMed Central
Keywords
License
Green

Abstract

Protection against ischaemia–reperfusion injury after revascularisation in acute myocardial infarction remains an enigma. Many targets have been identified, but after the failure of the recent Effect of Remote Ischaemic Conditioning on Clinical Outcomes in ST-elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention (CONDI2/ERIC-PPCI) trial to show translation to clinical benefit, there is still no pharmacological or mechanical strategy that has translated to clinical practice. This article addresses the results of the CONDI2/ERIC-PPCI trial in the context of previous studies of ischaemic conditioning, and then considers the prospects for other potential targets of cardioprotection. Finally, the authors examine the pitfalls and challenges in trial design for future investigation of cardioprotective strategies. In particular, this article highlights the need for careful endpoint and patient selection, as well as the need to pay attention to the biology of cardioprotection during the study.

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