CARDIOPROTECTIVE STRATEGIES AGAINST MYOCARDIAL ISCHEMIA–REPERFUSION INJURY

Abstract

Introduction: The incidence of ST-segment elevation myocardial infarction (STEMI) has demonstrated a decline in developed countries over the past two decades. However, despite widespread access to reperfusion therapy, the mortality associated with STEMI remains substantial. 

Objective: This review comprehensively explores the pathophysiology of acute myocardial infarction and reperfusion, encompassing the evolution of ischemic and reperfusion injuries, diverse modalities of cell death, and the resultant coronary microvascular dysfunction. Finally, we provide an in-depth discussion on efforts to translate cardioprotective drug therapies into clinical practice.

Results: While reperfusion is essential to rescue ischemic myocardium from imminent infarction, it also causes additional irreversible damage, leading to an augmented infarct size and microvascular dysfunction. 

Conclusion: Infarct size and MVO appear as two interrelated therapeutic targets for cardioprotection. Nevertheless, the implementation of effective cardioprotective strategies in clinical practice remains an unmet medical need.