Protecting the ischaemic and reperfused myocardium in acute myocardial infarction: distant dream or near reality?

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Abstract
The prerequisite for salvage of myocardium under threat of infarction is the return of coronary flow to the tissue as quickly as possible.2 , 3 The major clinical approach to reperfusion is the use of thrombolytics. However, fibrinolysis is not instantaneous and while the coronary thrombus is lysing, the subtended myocardium continues to undergo injury, which is ultimately irreversible. The administration of injury modifying manoeuvres could occur either before the onset of ischaemia, or after the onset of ischaemia but before therapeutic reperfusion.

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