Promising strategies to minimize reperfusion injury in STEMI.

Morbidity in patients presenting with acute ST-segment elevation myocardial infarction remains significant despite prompt reperfusion by primary percutaneous coronary intervention. This has been partly attributed to "myocardial reperfusion injury" whereby the process of restoring coronary blood flow paradoxically induces myocardial injury and cardiomyocyte death, mitigating the full beneficial effects of reperfusion. A large number of cardioprotective therapies to reduce myocardial infarct size have been investigated in preclinical and small proof-of-concept clinical studies with mixed results. In this article, we provide an overview of the most promising cardioprotective therapies for reducing myocardial infarct size that warrant further investigation in outcome studies.