Molecular Basis of Cardioprotective Effect of Antioxidant Vitamins in Myocardial Infarction

Abstract

Acute myocardial infarction (AMI) is the leading cause of mortality worldwide. Major advances in the treatment of acute coronary syndromes and myocardial infarction, using cardiologic interventions, such as thrombolysis or percutaneous coronary angioplasty (PCA) have improved the clinical outcome of patients. Nevertheless, as a consequence of these procedures, the ischemic zone is reperfused, giving rise to a lethal reperfusion event accompanied by increased production of reactive oxygen species (oxidative stress). These reactive species attack biomolecules such as lipids, DNA, and proteins enhancing the previously established tissue damage, as well as triggering cell death pathways. Studies on animal models of AMI suggest that lethal reperfusion accounts for up to 50% of the final size of a myocardial infarct, a part of the damage likely to be prevented. Although a number of strategies have been aimed at to ameliorate lethal reperfusion injury, up to date the beneficial effects in clinical settings have been disappointing. The use of antioxidant vitamins could be a suitable strategy with this purpose. In this review, we propose a systematic approach to the molecular basis of the cardioprotective effect of antioxidant vitamins in myocardial ischemia-reperfusion injury that could offer a novel therapeutic opportunity against this oxidative tissue damage.

Bcl6 knockdown aggravates hypoxia injury in cardiomyocytes via the P38 pathway

“…Increased ROS levels also increase proteolysis of excitation‐contraction coupling protein (Ayoub et al, ). Several preclinical and clinical studies have demonstrated the potential cardio‐protective value of antioxidants (Rodrigo et al, ; Zhang et al, ). Bcl6 protects against oxidative stress and apoptosis in macrophages and promotes M2‐like polarization (Jia et al, ).…”

The Role of Inflammation in Myocardial Infarction

“…Lastly, several studies have focused on vitamins (E and C) operating as free-radical scavengers and their potential as antioxidant and anti-inflammatory agents following acute MI. For more information on the matter, the reader is directed to a review publication by Rodrigo et al [289]. To sum up, studies on antioxidant strategies have not yet shown robust results, so more research is needed to ascertain whether they can demonstrate any potential benefits that can be utilized in the clinical setting.…”

Amelioration of persistent left ventricular function impairment through increased plasma ascorbate levels following myocardial infarction

“…7 Reperfusion functional injuries include the development of arrhythmias, microvascular damage, myocardial stunning and, perhaps most importantly, cell death, directly accounting for the infarct size. 8 It has been suggested that reperfusion damage may account for up to 50% of the final size of a myocardial infarct 2 and is therefore damage that may be preventable. The prevention of MRI is potentially translatable to meaningful clinical outcomes, such as a decreased left ventricular ejection fraction (LVEF).…”