PT  - JOURNAL ARTICLE
AU  - Michael F Oliver
TI  - Control of free fatty acids during acute myocardial ischaemia
AID  - 10.1136/hrt.2010.205534
DP  - 2010 Dec 01
TA  - Heart
PG  - 1883--1884
VI  - 96
IP  - 23
4099  - http://heart.bmj.com/content/96/23/1883.short
4100  - http://heart.bmj.com/content/96/23/1883.full
SO  - Heart2010 Dec 01; 96
AB  - During the onset of an acute coronary syndrome, an immediate increase in plasma free fatty acid (FFA) concentrations presents the ischaemic underperfused myocardium with a metabolic challenge to its survival. For the maintenance of contraction and to counter ventricular arrhythmias, parenteral treatment to reduce FFA availability should be available for paramedics when the patient is first seen. The best treatment options are insulin which partly inhibits FFA release from adipose tissue, immediate reduction of adipose tissue lipolysis, perhaps by new analogues of nicotinic acid, or measures to decrease the FFA/molar binding ratio with albumin. None has yet been tested in appropriate clinical trials.