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Myocardial ischemia-reperfusion injury: a neglected therapeutic target
Derek J. Hausenloy, Derek M. Yellon
Derek J. Hausenloy, Derek M. Yellon
Published January 2, 2013
Citation Information: J Clin Invest. 2013;123(1):92-100. https://doi.org/10.1172/JCI62874.
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Review Series

Myocardial ischemia-reperfusion injury: a neglected therapeutic target

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Abstract

Acute myocardial infarction (MI) is a major cause of death and disability worldwide. In patients with MI, the treatment of choice for reducing acute myocardial ischemic injury and limiting MI size is timely and effective myocardial reperfusion using either thombolytic therapy or primary percutaneous coronary intervention (PPCI). However, the process of reperfusion can itself induce cardiomyocyte death, known as myocardial reperfusion injury, for which there is still no effective therapy. A number of new therapeutic strategies currently under investigation for preventing myocardial reperfusion injury have the potential to improve clinical outcomes in patients with acute MI treated with PPCI.

Authors

Derek J. Hausenloy, Derek M. Yellon

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Figure 2

This figure illustrates the individual contributions of acute myocardial ischemic injury and myocardial reperfusion injury to final MI size (expressed in arbitrary units) in STEMI patients up to 24 hours following PPCI.

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This figure illustrates the individual contributions of acute myocardial...
The black solid line depicts the individual contributions to final MI size of acute myocardial ischemic injury and of myocardial reperfusion injury. The green dashed line depicts the theoretical MI size following PPCI based on acute myocardial ischemia alone in the absence of myocardial reperfusion injury. The red dashed line depicts the theoretical MI size based on acute myocardial ischemia alone in the absence of PPCI. The presence of myocardial reperfusion injury attenuates the benefit of PPCI in terms of the reduction of MI size. Therefore, the administration of a therapeutic strategy as an adjunct to PPCI that is capable of reducing myocardial reperfusion injury would result in a smaller MI size (as depicted by the green dashed line) and take advantage of full benefits of myocardial reperfusion. Figure modified from Cardiovascular Research (93).

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