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    The GTN patch: a simple and effective new approach to cardioprotection? 
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    • The GTN patch: a simple and effective new approach to cardioprotection?
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    The GTN patch: a simple and effective new approach to cardioprotection?

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    Published version (1.177Mb)
    Volume
    113
    Pagination
    20 - ?
    DOI
    10.1007/s00395-018-0681-2
    Journal
    Basic Res Cardiol
    Issue
    3
    Metadata
    Show full item record
    Abstract
    There remains a significant un-met need to reduce the extent of myocardial injury caused by ischaemia and reperfusion injury in patients experiencing an ST-elevation MI. Although nitric oxide is central to many cardioprotective strategies currently undergoing investigation, cardioprotection from the delivery of nitrates/nitrites has been inconsistently observed. The route of administration appears to be a critical variable. The glyceryl trinitrate (GTN) patch is commonly used as a simple and practical means of delivering nitric oxide to patients with ischaemic heart disease, but whether acute cardioprotection can be achieved by application of a GTN patch has not been investigated before. Here, we use a mouse model to demonstrate that a GTN patch is highly cardioprotective when applied immediately prior to 40 min occlusion of the left anterior coronary artery followed by 2 h reperfusion, reducing infarct size from 54 ± 4% in control mice, to 28 ± 4% (P < 0.001, N = 7). The degree of protection was similar to that achieved with a standard remote ischaemic preconditioning protocol. Furthermore, and of greater potential clinical relevance, a GTN patch was also protective when applied well after the initiation of ischaemia and 15 min prior to reperfusion (28 ± 4 vs 59 ± 4%; P < 0.01, N = 5). Confirmatory experiments verified the expected effect increase in plasma nitrite levels and decrease in blood pressure. The simplicity and rapidity of GTN patch application (easily applied in an ambulance or cardiac catheterization laboratory), and low cost (potentially relevant to low-income countries), make it attractive for further investigation.
    Authors
    Yellon, DM; He, Z; Khambata, R; Ahluwalia, A; Davidson, SM
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/41443
    Collections
    • Centre for Clinical Pharmacology [719]
    Language
    eng
    Licence information
    Creative Commons Attribution License
    Copyright statements
    The Author(s) 2018
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