Peptides are cardioprotective drugs of the future. Glucagon-like peptide-1

The high mortality rate of patients with acute myocardial infarction (AMI) remains the most pressing issue of modern cardiology. Over the past 10 years, there has been no significant reduction in mortality among patients with AMI. It is quite obvious that there is an urgent need to develop fundamentally new drugs for the treatment of AMI. Glucagon-like peptide-1 receptor (GLP1R) agonists have some promise in this regard. GLP1R agonists have been shown to be able to prevent both ischemic and reperfusion injury to the heart. These compounds not only reduce infarct size, but also improve recovery of cardiac contractility in reperfusion. There is evidence that GLP1R agonists prevent adverse post-infarction remodeling of the heart. These data suggest a need of clinical trials of GLP1R agonists in patients with AMI and percutaneous coronary intervention. Inhibitors of dipeptidyl peptidase-4 which hydrolyzes glucagon-like peptide-1 to inactive peptides have similar positive effects. It has been shown that kinases, heme oxygenase-1 and NO-synthase are involved in the cardioprotective effect of GLP1R agonists.