Haemoglobin-based oxygen carriers and myocardial infarction
The incidence of investigator diagnosed myocardial infarction (MI) is greater in patients treated with haemoglobin-based oxygen carriers (HBOCs) than controls. Clinical trials and literature pertaining to possible HBOC toxicity mechanisms have been analyzed in order to identify possible reasons for...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-12-01
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| Series: | Artificial Cells, Nanomedicine, and Biotechnology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/21691401.2019.1573181 |
| _version_ | 1828365540054269952 |
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| author | Timothy N. Estep |
| author_facet | Timothy N. Estep |
| author_sort | Timothy N. Estep |
| collection | DOAJ |
| description | The incidence of investigator diagnosed myocardial infarction (MI) is greater in patients treated with haemoglobin-based oxygen carriers (HBOCs) than controls. Clinical trials and literature pertaining to possible HBOC toxicity mechanisms have been analyzed in order to identify possible reasons for this imbalance. MI diagnosis is hampered by potential interference of troponin assays by haemoglobin, haemolysis and bilirubin. Nevertheless, insofar as the reported incidence correlates with actual occurrence, there is a positive relationship between MI and HBOC dose and size. Preclinical and clinical data suggest that direct cardiac toxicity and coronary vasoconstriction are unlikely. More probable are detrimental intravascular interactions between HBOCs and components of the coagulation cascade, particularly dysfunctional endothelium. Elucidation of mechanisms is impeded by a lack of clinical data. Measurement of relevant biomarkers would be extremely useful in this regard and in improving patient selection criteria. Conduct of clinical trials in carefully selected patient populations after the development of improved protocols for MI diagnosis, along with concomitant biomarker data collection, is recommended. |
| first_indexed | 2024-04-14T05:33:28Z |
| format | Article |
| id | doaj.art-08707fde018a4f9f9732ce8ad57df328 |
| institution | Directory Open Access Journal |
| issn | 2169-1401 2169-141X |
| language | English |
| last_indexed | 2024-04-14T05:33:28Z |
| publishDate | 2019-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Artificial Cells, Nanomedicine, and Biotechnology |
| spelling | doaj.art-08707fde018a4f9f9732ce8ad57df3282022-12-22T02:09:44ZengTaylor & Francis GroupArtificial Cells, Nanomedicine, and Biotechnology2169-14012169-141X2019-12-0147159360110.1080/21691401.2019.1573181Haemoglobin-based oxygen carriers and myocardial infarctionTimothy N. Estep0Chart Biotech Consulting, LLC, Erie, CO, USAThe incidence of investigator diagnosed myocardial infarction (MI) is greater in patients treated with haemoglobin-based oxygen carriers (HBOCs) than controls. Clinical trials and literature pertaining to possible HBOC toxicity mechanisms have been analyzed in order to identify possible reasons for this imbalance. MI diagnosis is hampered by potential interference of troponin assays by haemoglobin, haemolysis and bilirubin. Nevertheless, insofar as the reported incidence correlates with actual occurrence, there is a positive relationship between MI and HBOC dose and size. Preclinical and clinical data suggest that direct cardiac toxicity and coronary vasoconstriction are unlikely. More probable are detrimental intravascular interactions between HBOCs and components of the coagulation cascade, particularly dysfunctional endothelium. Elucidation of mechanisms is impeded by a lack of clinical data. Measurement of relevant biomarkers would be extremely useful in this regard and in improving patient selection criteria. Conduct of clinical trials in carefully selected patient populations after the development of improved protocols for MI diagnosis, along with concomitant biomarker data collection, is recommended.https://www.tandfonline.com/doi/10.1080/21691401.2019.1573181Haemoglobin-based oxygen carriersmyocardial infarctiontroponinvasoconstriction |
| spellingShingle | Timothy N. Estep Haemoglobin-based oxygen carriers and myocardial infarction Artificial Cells, Nanomedicine, and Biotechnology Haemoglobin-based oxygen carriers myocardial infarction troponin vasoconstriction |
| title | Haemoglobin-based oxygen carriers and myocardial infarction |
| title_full | Haemoglobin-based oxygen carriers and myocardial infarction |
| title_fullStr | Haemoglobin-based oxygen carriers and myocardial infarction |
| title_full_unstemmed | Haemoglobin-based oxygen carriers and myocardial infarction |
| title_short | Haemoglobin-based oxygen carriers and myocardial infarction |
| title_sort | haemoglobin based oxygen carriers and myocardial infarction |
| topic | Haemoglobin-based oxygen carriers myocardial infarction troponin vasoconstriction |
| url | https://www.tandfonline.com/doi/10.1080/21691401.2019.1573181 |
| work_keys_str_mv | AT timothynestep haemoglobinbasedoxygencarriersandmyocardialinfarction |