Acute coronary syndrome (ACS) is a pathophysiology in which acute thrombotic occlusion occurs at the site of plaque rupture or erosion followed by sudden onset of myocardial ischemia and chest pain. ...This syndrome includes ST elevation myocardial infarction, non-ST elevation Myocardial Infarction, and unstable angina as well as sudden cardiac death. The pathophysiology varies widely in its severity of symptoms, signs and prognosis. With regard to diagnosis, it is crucial to monitor the type and degree of ischemia, which can change from time to time. Essential diagnostic clues include the patient's symptoms, physical findings and electrocardiogram. In addition, troponin T and other serum markers have recently been introduced for diagnostic tools at the bedside. Treatment should be initiated immediately, including control of chest pain, reduction of myocardial ischemia, coronary revascularization, and prevention of recurrence. This review summarizes the current therapeutic strategy for acute coronary syndrome.
Targeting the ischemic myocardium in the setting of coronary artery disease is usually hampered by the impaired arterial perfusion of the region of interest. Retroinfusion of the coronary veins has ...gained attention for therapeutic approaches which target drugs, genes or cells to ischemic myocardium. Besides anatomy of the coronary venous system, the pressure flow relationship during retroinfusion and the efficacy of pressure-regulated selective retroinfusion for targeted delivery of drugs is reported. Moreover, we describe adenoviral and liposomal gene transfer into ischemic and non-ischemic myocardium, outline studies in chronic ischemic preclinical models treated by retroinfusion of pro-angiogenic agents and discuss the impact of retroinfusion for cell-based regenerative therapy of the diseased myocardium
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