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Rigshospitalet - a part of Copenhagen University Hospital
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Targeting reperfusion injury in the era of primary percutaneous coronary intervention: hope or hype?

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  2. Alcohol septal ablation in patients with severe septal hypertrophy

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  3. Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

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  4. Outcome after heart-lung or lung transplantation in patients with Eisenmenger syndrome

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  1. Fractional Flow Reserve Guided PCI in Patients With and Without Left Ventricular Hypertrophy: a DANAMI-3-PRIMULTI Sub-study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Myocardial damage after ST-segment elevation myocardial infarction by use of bivalirudin or heparin: a DANAMI-3 substudy

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  3. Potassium Disturbances and Risk of Ventricular Fibrillation Among Patients With ST-Segment-Elevation Myocardial Infarction

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  4. Interaction of ischaemic postconditioning and thrombectomy in patients with ST-elevation myocardial infarction

    Research output: Contribution to journalJournal articleResearchpeer-review

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Introduction of reperfusion therapy by primary percutaneous coronary intervention (PCI) has resulted in improved outcomes for patients presenting with ST-segment elevation myocardial infarction. Despite the obvious advantages of primary PCI, acute restoration of blood flow paradoxically also jeopardises the myocardium in the first minutes of reperfusion-a phenomenon known as reperfusion injury. Prevention of reperfusion injury may help to improve outcome following primary PCI. This review focuses on the clinical evidence of potential therapeutic cardioprotective methods as adjuvant to primary PCI. Despite overall disappointing, there exists some promising strategies, including ischaemic postconditioning, remote ischaemic conditioning, pharmacological conditioning with focus on adenosine, cyclosporine A, glucose-insulin-potassium, exenatide, atrial natriuretic peptide and metoprolol and cooling. But hitherto no large randomised study has demonstrated any effect on outcome, and ongoing studies that address this issue are underway. Moreover, this review will discuss important clinical predictors associated with reperfusion injury during primary PCI that may interfere with a potential protective effect (pre-PCI thrombolysis in myocardial infarction flow, preinfarction angina, collateral flow, duration of ischaemia and hyperglycaemia). This paper will also provide a short overview of the technical issues related to surrogate endpoints in phase II trials. Based upon these discussions, the paper will provide factors that should be taken into account when designing future clinical studies.

Original languageEnglish
JournalHeart (British Cardiac Society)
Volume101
Issue number20
Pages (from-to)1612-8
Number of pages7
ISSN1355-6037
DOIs
Publication statusPublished - Oct 2015

    Research areas

  • Humans, Ischemic Postconditioning, Myocardial Reperfusion Injury, Percutaneous Coronary Intervention, Treatment Outcome

ID: 46196937