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Efforts to Limit the Size of Myocardial Infarcts

[+] Article, Author, and Disclosure Information

Grant support: in part by grants RO1-HL-23140-03, N01-HV-7-2940, P-50-HL-26215-02, and T32-HL-7049-03 from the National Heart, Lung, and Blood Institute.

▸Requests for reprints should be addressed to James E. Muller, M.D.; Harvard Medical School, 164 Longwood Avenue; Boston, MA 02115.

Boston, Massachusetts

© 1981 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1981;95(6):736-761. doi:10.7326/0003-4819-95-6-736
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Throughout the last decade, multiple interventions have been shown to decrease myocardial ischemic injury and limit infarct size in animal models of acute myocardial infarction. Results of pilot studies have suggested that some of these interventions may also have beneficial effects in humans with evolving myocardial infarction. This review focuses on the rationale for limiting infarct size, efficacy of methods for estimating size of infarcts, and current clinical data on specific intervention therapy. No intervention has yet been proved sufficiently efficacious to warrant its routine clinical use. However, treatment with β-adrenergic blockers, intravenous nitroglycerin, and hyaluronidase has been shown to affect one or more indexes of infarct size in patients with acute myocardial infarction. Large, randomized clinical trials of these and other promising interventions are underway and will provide data on whether infarct size can be limited in humans and whether residual cardiac function and patient prognosis can thereby be improved.





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