Cardiovascular Pharmacology: Open Access

Abstract

Acute Myocardial Injury: A Perspective on Lethal Reperfusion Injury

Kingma JG

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 the 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.