Cardiac Ischaemia–Reperfusion Injury: Pathophysiology, Therapeutic Targets and Future Interventions

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Abstract
Advancements in the medical field, particularly in cardiovascular diseases, have significantly improved the diagnosis, management, and prevention of life-threatening presentations and comorbidities. Despite this progress, cardiovascular diseases continue to place a substantial burden on healthcare systems, contributing to nearly 32% of all global deaths according to the World Health Organisation. A predominant complication arising from the treatment of cardiovascular diseases is cardiac ischaemia–reperfusion (I/R) injury, which occurs when blood supply is restored to the myocardium following a period of ischaemia, paradoxically resulting in further tissue damage. There are multiple factors involved in complex pathophysiology and complicated clinical outcomes. Although various therapeutic strategies have been explored to mitigate this injury, an optimal solution has yet to be identified. Therapeutic approaches such as pharmacological interventions and molecular therapy have shown promising prospects in this field. Ongoing research aims to address this unresolved issue, which continues to pose significant challenges for both patients and healthcare professionals. This review aims to explore the multitude of underlying mechanisms of ischaemia–reperfusion injury, and identify current knowledge gaps and new emerging therapeutic interventions.

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