Ischemia/reperfusion injury: Pharmacological treatment options
[Pages:32]Physiologisches Institut
Ischemia/reperfusion injury: Pharmacological treatment
options
PD Dr. Kerstin Boengler
Plaque rupture and myocardial ischemia
Acute plaque rupture (Stary VI)
Ischemic myocardium (ACS, NSTEMI, STEMI)
Plaque ruptur, thrombosis and myocardial death
Stable plaque Unstable plaque, plaque ruptur
% MI-Patients
75
60
45 68
30
15
18
14
0
< 50
50-70
> 70
Diameter stenosis (%)
Falk et al., Circulation 92: 657-671, 1995
Ischemic injury
Myocardial damage
TIME IS MUSCLE
Ischemia
IschemicInjury
Time
Ischemia-reperfusion injury
Ischemia
Infarct size (% area at risk)
100
80
Pig Rabbit
Humans
60 Rat
40
20 0 0 20
Dog
Cat
Guinea pig
45
90
180
Extent of collaterals
360 (min)
Schaper et al., Prog Cardiovasc Dis 31: 57-77,1988
Patient
Myocardial infarction and prognosis
6 Month mortality (%)
Infarct size (% area at risk)
Burns et al., J Am Coll Cardiol 39:30?36, 2002
Patient
CHD
Duration of ischemia and mortality
Mortality (%)
Cumulative mortality (Kaplan-Meier) in patients with STEMI and PCI (n=6.209)
30
Duration of ischemia
in minutes
20
0-60
61-120
121-180
10
181-360
Log-Rank p ................
................
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