Reperfusion Injury in Patients With Acute Myocardial Infarction: JACC Scientific Statement.

Document Type

Article

Publication Date

6-4-2024

Publication Title

Journal of the American College of Cardiology

Abstract

Despite impressive improvements in the care of patients with ST-segment elevation myocardial infarction, mortality remains high. Reperfusion is necessary for myocardial salvage, but the abrupt return of flow sets off a cascade of injurious processes that can lead to further necrosis. This has been termed myocardial ischemia-reperfusion injury and is the subject of this review. The pathologic and molecular bases for myocardial ischemia-reperfusion injury are increasingly understood and include injury from reactive oxygen species, inflammation, calcium overload, endothelial dysfunction, and impaired microvascular flow. A variety of pharmacologic strategies have been developed that have worked well in preclinical models and some have shown promise in the clinical setting. In addition, there are newer mechanical approaches including mechanical unloading of the heart prior to reperfusion that are in current clinical trials.

Volume

83

Issue

22

First Page

2196

Last Page

2213

DOI

10.1016/j.jacc.2024.02.056

ISSN

1558-3597

PubMed ID

38811097

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