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Open Access Review

Optimising cardioprotection during myocardial ischaemia: targeting potential intracellular pathways with glucagon-like peptide-1

Sophie J Clarke, Liam M McCormick and David P Dutka*

Author Affiliations

Department of Cardiovascular Medicine, University of Cambridge, Addenbrooke’s Hospital, Cambridge, UK

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Cardiovascular Diabetology 2014, 13:12  doi:10.1186/1475-2840-13-12

Published: 11 January 2014

Abstract

Coronary heart disease and type-2 diabetes are both major global health burdens associated with an increased risk of myocardial infarction (MI). Following MI, ischaemia-reperfusion injury (IRI) remains a significant contributor to myocardial injury at the cellular level. Research has focussed on identifying a strategy or intervention to minimise IRI to optimise reperfusion therapy, with the aim of delivering a superior clinical outcome. The incretin hormone glucagon-like peptide-1, already an established basis for the treatment of type-2 diabetes, also has the potential to protect against IRI. We explain the physiology and cellular processes involved in IRI, and the intracellular pathways activated by GLP-1, which could intercept IRI and deliver cardioprotection. The review also examines the current preclinical and clinical evidence for GLP-1 in cardioprotection and future directions for research as we look for an effective adjunctive treatment to minimise IRI.

Keywords:
GLP-1; Glucagon-like peptide-1; Incretin; Ischaemia; Ischaemia-reperfusion; Cardioprotection; Myocardial metabolism; Diabetes; Percutaneous coronary intervention; Myocardial infarction