Key result
Timely reperfusion of the infarct-related artery remains the most effective intervention to reduce mortality in acute myocardial infarction, although the existence of lethal reperfusion injury remains debated.
This review highlights the mechanisms of lethal reperfusion injury and the ongoing challenges in translating cytoprotective strategies from experimental models to clinical practice.
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Reperfusion remains the primary AMI intervention; leaves open whether lethal reperfusion injury can be targeted in trials.
Acute myocardial infarction contributes significantly to mortality in patients with coronary artery disease. Timely reperfusion of an infarct-related artery within a reasonable time-frame after acute coronary occlusion continues to be the most effective intervention in patients to reduce morbidity and mortality. However, restoration of blood flow to reversibly injured cardiocytes (and other cardiac cell types) within the under-perfused region may also provoke additional damage-commonly referred to as lethal reperfusion injury. Debate has gone on, and continues regarding the existence of reperfusion injury and the pathways that are solicited. Consequently, findings from fundamental science studies have facilitated identification of therapeutic targets that may benefit patients with acute coronary syndromes. This review examines evidence from basic science and clinical studies that support the premise of cardiac injury caused by reperfusion. Pathogenesis of post-ischemic cellular injury is discussed along with potential interventions (pharmacologic and non-pharmacologic) currently being used to improve clinical outcomes.
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Kingma Jg (2017) conducted a review in Acute Myocardial Infarction and Reperfusion Injury. Reperfusion therapy and cardioprotection strategies was evaluated. Timely reperfusion of the infarct-related artery remains the most effective intervention to reduce mortality in acute myocardial infarction, although the existence of lethal reperfusion injury remains debated.
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