microRNAs (miRNAs), small non-coding RNA molecules that act as negative regulators of
gene expression, are involved in a wide range of biological functions and control several cellular processes.
This review illustrates miRNA regulation and function in tissue response to acute ischemia, focusing
on miRNA role in acute myocardial infarction and describing a subset of miRNAs de-regulated upon
cardiac ischemia. These miRNAs may represent “master ischemic” miRNAs, playing a pathogenetic role
in one of the different components of tissue response to ischemia. Moreover, circulating miRNAs correlated
to myocardial infarction and examples of miRNA involvement in ischemic diseases different from cardiac ischemia are
also discussed. The identification of specific miRNAs as key regulators of cell biology has opened new clinical avenues, and
may allow new diagnostic and/or prognostic tools development, as much as innovative therapeutic strategies. Two paradigmatic
reports, in which miRNAs have been targeted to improve cardiac function in pre-clinical models of myocardial infarction,
are described in detail and confirmed the efficacy of these strategies.