Kleinbongard, P;
Bøtker, HE;
Ovize, M;
Hausenloy, DJ;
Heusch, G;
(2019)
Co-morbidities and co-medications as confounders of cardioprotection - does it matter in the clinical setting?
British Journal of Pharmacology
10.1111/bph.14839.
(In press).
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Abstract
The translation of cardioprotection from robust experimental evidence to clinical outcome benefit for patients suffering acute myocardial infarction or undergoing cardiovascular surgery has been largely disappointing. The present review attempts to critically analyse the evidence for confounders of cardioprotection in patients with acute myocardial infarction and in patients undergoing cardiovascular surgery. One reason that has been proposed to be responsible for such lack of translation is the confounding of cardioprotection by co‐morbidities and co‐medications. Whereas there is solid experimental evidence for such confounding of cardioprotection by single co‐morbidities and co‐medications, the clinical evidence from retrospective analyses of the limited number of clinical data is less robust. The best evidence for interference of co‐medications is that for platelet inhibitors to recruit cardioprotection per se and thus limit the potential for further protection from myocardial infarction and for propofol anaesthesia to abrogate protection from remote ischaemic conditioning in cardiovascular surgery.
| Type: | Article |
|---|---|
| Title: | Co-morbidities and co-medications as confounders of cardioprotection - does it matter in the clinical setting? |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/bph.14839 |
| Publisher version: | https://doi.org/10.1111/bph.14839 |
| Language: | English |
| Additional information: | Copyright © 2019 The Authors. British Journal of Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | acute myocardial infarction, cardioprotection, cardiovascular surgery, ischaemic conditioning, myocardial ischaemia, reperfusion |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Pre-clinical and Fundamental Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10080567 |
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