Therapy Against Ischemic Injury
Giacinta Guarini, Alda Huqi, Paola Capozza, Doralisa Morrone, Francesca Donati and Mario Marzilli
Affiliation: Cardiovascular Medicine Division, Cardio-Thoracic and Vascular Department, Via Paradisa 2, 56124 Pisa (Pi).
The advent of reperfusion therapy constituted a historical change for the management of myocardial infarction (MI) patients.
However, shortly after, experimental models recognized an intrinsic damage, related to reperfusion itself, which was termed as ischemiareperfusion
injury (IRI). Clinical studies attribute IRI a significant burden of morbidity and mortality observed in patients undergoing
successful epicardial reperfusion. Several mechanisms have been identified and, as many strategies, have been investigated to address the
phenomenon. In this review we will discuss the current evidence for IRI, pharmacological and non-pharmacological preventive strategies
adopted both in experimental models and in clinical practice. Finally, we will try to provide a critical appraisal to the lack of consistent
benefit observed in translational medicine.
Keywords: Ischemia-reperfusion injury, no reflow, preconditioning, postconditioning, mPTP, RISK and SAFE pathways, mitochondria,
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