Postconditioning against ischaemia-reperfusion injury: ready for wide application in patients?

Extract

In patients presenting with acute myocardial infarction (AMI), infarct size can be limited by early myocardial reperfusion via percutaneous coronary intervention (PCI), thereby preserving left ventricular systolic function and improving clinical outcome. However, restoring blood flow after a prolonged ischaemic episode may also paradoxically cause irreversible damage to the myocardium. This so-called reperfusion injury leads to the death of cardiomyocytes that are still viable at the end of ischaemia and may account for up to 50% of the final infarct size in animal models. Although the experimental data regarding reperfusion injury limiting strategies are promising, translation into clear clinical benefit has proven difficult.2 Nevertheless, cardioprotective strategies that limit reperfusion injury and hence further enhance the benefit of reperfusion are of major clinical interest and are needed to improve the efficacy of primary PCI. …