The Disconnect Between Bench and Bedside
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Early reperfusion by primary percutaneous intervention in patients with ST-segment–elevation myocardial infarction limits infarct size and preserves left ventricular systolic function, thereby improving prognosis. Despite this process of restoring blood flow to salvage the myocardium, further myocardial damage can occur as a consequence of reperfusion. This is known as myocardial ischemia/reperfusion injury (IRI).
Many cardioprotective therapies aimed at reducing IRI have been successfully examined in the preclinical setting. Despite attenuating IRI at the bench, not all have subsequently demonstrated a reduction in infarct size at the bedside, and none have demonstrated clinical benefits.
The failure to translate cardioprotective therapies into the clinical setting can be attributed to many factors, from inadequate animal models of infarction to poor clinical study designs. Overall, it seems that hopes are fading that any cardioprotective intervention will ever materialize. However, after thoroughly dissecting the issues, we have come to a relevant diagnosis that we call a disconnection paradigm. This condition refers to the complete disconnect between preclinical and clinical studies in …