Pharmacological Agents in the Clinic: Trial and Error

Abstract

Following an explosion of molecular and cellular research in the last 50 years, the study of specific molecular targets in the context of heart failure has generated much excitement. With the incidence of heart failure rising worldwide, new pharmacological agents are eagerly anticipated as a key tool with the potential for significant impact. In this regard, the results of the keenly awaited Does Cyclosporine Improve Clinical Outcome in ST Elevation Myocardial Infarction Patients (CIRCUS) trial have just been made available. Despite a substantial programme of supporting experimental and preclinical evidence however, the results have proved negative. This is of great disappointment to the clinical and scientific community. Here, this is discussed in the context of previous studies and future directions explored. TARGETING MYOCARDIAL REPERFUSION INJURY TO MITIGATE HEART FAILURE Molecular treatment regimens were first introduced into standard clinical practice in the 1980's but have not changed substantially since. 1 Myocardial infarction is one of the most widespread causes of secondary events, heart failure and death 2,3 and patients with ST-segment Elevation Myocardial Infarction (STEMI) are a particularly high risk group. The extent of cell death in infarction i.e. infarct size, is suggested to be a major determinant in the likelihood of survival. 4-6 Since myocardial reperfusion injury contributes greatly to the final infarct size, treatments that mitigate this have garnered significant interest.

Breaking Female Hearts: The Gender Gap in Cardiovascular Research

“…16 The reasons for this have been debated, 17 however sex related differences have not been discussed. This study comprised over 80% males in control and treatment groups.…”