Evidence map›Paper›PMID 32620851›Full record

ReviewNature reviews. Cardiology2020

Myocardial ischaemia-reperfusion injury and cardioprotection in perspective.

Gerd Heusch

Registry-linked trialAbstract readReview
PubMed Publisher
In one paragraph

Review in Nature reviews. Cardiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04912518 (Cardioprotective Effect of Dexmedetomidine in Patients With ST-segment Elevation Myocardial Infarction), which is not on this map. Cited by 700 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
700citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04912518 narecruitingnot on this mapstarted 2021, after this paper: background citation

Cardioprotective Effect of Dexmedetomidine in Patients With ST-segment Elevation Myocardial Infarction: a Double-Blind, Multicenter, Randomized, Placebo-Controlled Clinical Trial

TypeinterventionalSponsorHarbin Medical UniversityRan2021 to 2025Enrolled250ConditionsST-segment Elevation Myocardial Infarction (STEMI), Percutaneous Coronary Intervention, CardioprotectionArmsDexmedetomidine (DEX), Placebo (Saline)
3 · Its place in the literature

Who cites it

700 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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640 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

1 author.

Gerd HeuschInstitute for Pathophysiology, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany. gerd.heusch@uk-essen.de.ORCID 0000-0001-7078-4160

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Despite the increasing use and success of interventional coronary reperfusion strategies, morbidity and mortality from acute myocardial infarction are still substantial. Myocardial infarct size is a major determinant of prognosis in these patients. Therefore, cardioprotective strategies aim to reduce infarct size. However, a perplexing gap exists between the many preclinical studies reporting infarct size reduction with mechanical and pharmacological interventions and the poor translation into better clinical outcomes in patients. This Review revisits the pathophysiology of myocardial ischaemia-reperfusion injury, including the role of autophagy and forms of cell death such as necrosis, apoptosis, necroptosis and pyroptosis. Other cellular compartments in addition to cardiomyocytes are addressed, notably the coronary microcirculation. Preclinical and clinical research developments in mechanical and pharmacological approaches to induce cardioprotection, and their signal transduction pathways, are discussed. Additive cardioprotective interventions are advocated. For clinical translation into treatments for patients with acute myocardial infarction, who typically are of advanced age, have comorbidities and are receiving several medications, not only infarct size reduction but also attenuation of coronary microvascular obstruction, as well as longer-term targets including infarct repair and reverse remodelling, must be considered to improve patient outcomes. Future clinical trials must focus on patients who really need adjunct cardioprotection, that is, those with severe haemodynamic alterations.

Indexed as

Myocardial Reperfusion InjuryHumans

Identifiers

PMID32620851

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.