TY - JOUR
T1 - Perioperative Cardioprotection: Clinical Implications
AU - Roth, Sebastian
AU - Torregroza, Carolin
AU - Huhn, Ragnar
AU - Hollmann, Markus W.
AU - Preckel, Benedikt
PY - 2020
Y1 - 2020
N2 - Perioperative cardioprotection aims to minimize the consequences of myocardial ischemia-reperfusion injury. In isolated tissue and animal experiments, several treatments have been identified providing cardioprotection. Some of these strategies have been confirmed in clinical proof-of-concept studies. However, the final translation of cardioprotective strategies to really improve clinical outcome has been disappointing: large randomized controlled clinical trials mostly revealed inconclusive, neutral, or negative results. This review provides an overview of the currently available evidence regarding clinical implications of perioperative cardioprotective therapies from an anesthesiological perspective, highlighting nonpharmacological as well as pharmacological strategies. We discuss reasons why translation of promising experimental results into clinical practice and outcome improvement is hampered by potential confounders and suggest future perspectives to overcome these limitations.
AB - Perioperative cardioprotection aims to minimize the consequences of myocardial ischemia-reperfusion injury. In isolated tissue and animal experiments, several treatments have been identified providing cardioprotection. Some of these strategies have been confirmed in clinical proof-of-concept studies. However, the final translation of cardioprotective strategies to really improve clinical outcome has been disappointing: large randomized controlled clinical trials mostly revealed inconclusive, neutral, or negative results. This review provides an overview of the currently available evidence regarding clinical implications of perioperative cardioprotective therapies from an anesthesiological perspective, highlighting nonpharmacological as well as pharmacological strategies. We discuss reasons why translation of promising experimental results into clinical practice and outcome improvement is hampered by potential confounders and suggest future perspectives to overcome these limitations.
UR - http://www.scopus.com/inward/record.url?scp=85096072065&partnerID=8YFLogxK
U2 - https://doi.org/10.1213/ANE.0000000000005234
DO - https://doi.org/10.1213/ANE.0000000000005234
M3 - Review article
C2 - 33186162
SN - 0003-2999
VL - 131
SP - 1751
EP - 1764
JO - Anesthesia and analgesia
JF - Anesthesia and analgesia
IS - 6
ER -