cGMP at the centre of attention: emerging strategies for activating the cardioprotective PKG pathway

The nitric oxide (NO)–protein kinase G (PKG) pathway has been known for some time to be an important target for cardioprotection against ischaemia/reperfusion injury and heart failure. While many approaches for reducing infarct size in patients have failed in the past, the advent of novel drugs that modulate cGMP and its downstream targets shows very promising results in recent preclinical and clinical studies. Here, we review main aspects of the NO–PKG pathway in light of recent drug development and summarise potential cardioprotective strategies in which cGMP is the main player.