On the edge: targeting Toll-like receptor 2 in ischemia/reperfusion injury.

Coronary heart disease is an inflammatory disorder of the coronary vessels. With a prevalence of approximately 20% in the general population, it is an endemic problem in industrialized countries. It has been the leading cause of death in the past 80 years or so in the United States. Coronary heart disease may lead to acute coronary syndromes. These cover a wide spectrum of clinical presentations including unstable angina, non–ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction, and sudden cardiac death. The common anatomic substrate of acute coronary syndromes is coronary thrombosis or rupture of an atherosclerotic plaque leading to an obstruction of the vessel and subsequent ischemia in the corresponding myocardial area. Thus, prompt reperfusion by primary percutaneous coronary intervention or fibrinolysis combined with early percutaneous coronary intervention is the gold standard in treatment to improve clinical outcome.1–3 Adjuvant treatment measures include antiplatelet agents, anticoagulants, and anti-ischemic therapy together with analgesic agents, to restore blood flow and diminish myocardial necrosis associated with prolonged ischemia.