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oai:repisalud.isciii.es:20.500.12105/94832024-09-27T09:26:28Zcom_20.500.12105_19604com_20.500.12105_2051col_20.500.12105_19605

00925njm 22002777a 4500 dc Rossello, Xavier author Lobo-Gonzalez, Manuel author Ibáñez, Borja author 2019-08 There is a need to find interventions able to reduce the extent of injury in reperfused ST-segment elevation myocardial infarction (STEMI) beyond timely reperfusion. In this review, we summarise the clinical impact of STEMI from epidemiological, clinical and biological perspectives. We also revise the pathophysiology underlying the ischaemia/reperfusion syndrome occurring in reperfused STEMI, including the several players involved in this syndrome, such as cardiomyocytes, microcirculation and circulating cells. Interventions aimed to reduce the resultant infarct size, known as cardioprotective therapies, are extensively discussed, putting the focus on both mechanical interventions (i.e. ischaemic conditioning) and promising pharmacological therapies, such as early intravenous metoprolol, exenatide and other glucose modulators, N-acetylcysteine as well as on some other classic therapies which have failed to be translated to the clinical arena. Novel targets for evolving therapeutic interventions to ameliorate ischaemia/reperfusion injury are also discussed. Finally, we highlight the necessity to improve the study design of future randomised clinical trials in the field, as well as to select patients better who can most likely benefit from cardioprotective interventions. Eur Heart J Acute Cardiovasc Care. 2019; 8(5):443-56 10.1177/2048872619845283 2048-8734 2048-8726 European heart journal. Acute cardiovascular care 31172789 http://hdl.handle.net/20.500.12105/9483 Ischaemia/reperfusion injury Acute myocardial infarction Cardioprotection Editor's Choice- Pathophysiology and therapy of myocardial ischaemia/reperfusion syndrome