Multitarget Strategies to Reduce Myocardial Ischemia/Reperfusion Injury: JACC Review Topic of the Week

Sean M. Davidson, Péter Ferdinandy, Ioanna Andreadou, Hans Erik Bøtker, Gerd Heusch, Borja Ibáñez, Michel Ovize, Rainer Schulz, Derek M. Yellon, Derek J. Hausenloy, David Garcia-Dorado

Research output: Contribution to journalReview articleResearchpeer-review

192 Citations (Scopus)


© 2019 The Authors Many treatments have been identified that confer robust cardioprotection in experimental animal models of acute ischemia and reperfusion injury. However, translation of these cardioprotective therapies into the clinical setting of acute myocardial infarction (AMI) for patient benefit has been disappointing. One important reason might be that AMI is multifactorial, causing cardiomyocyte death via multiple mechanisms, as well as affecting other cell types, including platelets, fibroblasts, endothelial and smooth muscle cells, and immune cells. Many cardioprotective strategies act through common end-effectors and may be suboptimal in patients with comorbidities. In this regard, emerging data suggest that optimal cardioprotection may require the combination of additive or synergistic multitarget therapies. This review will present an overview of the state of cardioprotection today and provide a roadmap for how we might progress towards successful clinical use of cardioprotective therapies following AMI, focusing on the rational combination of judiciously selected, multitarget therapies. This paper emerged as part of the discussions of the European Union (EU)-CARDIOPROTECTION Cooperation in Science and Technology (COST) Action, CA16225.
Original languageEnglish
Pages (from-to)89-99
JournalJournal of the American College of Cardiology
Issue number1
Publication statusPublished - 8 Jan 2019


  • cardioprotection
  • ischemia
  • myocardial infarction
  • reperfusion


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