{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T11:12:36Z","timestamp":1789902756979,"version":"4.0.1"},"reference-count":313,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The significant reduction in \u2018ischemic time\u2019 through capillary diffusion of primary percutaneous intervention (pPCI) has rendered myocardial-ischemia reperfusion injury (MIRI) prevention a major issue in order to improve the prognosis of ST elevation myocardial infarction (STEMI) patients. In fact, while the ischemic damage increases with the severity and the duration of blood flow reduction, reperfusion injury reaches its maximum with a moderate amount of ischemic injury. MIRI leads to the development of post-STEMI left ventricular remodeling (post-STEMI LVR), thereby increasing the risk of arrhythmias and heart failure. Single pharmacological and mechanical interventions have shown some benefits, but have not satisfactorily reduced mortality. Therefore, a multitarget therapeutic strategy is needed, but no univocal indications have come from the clinical trials performed so far. On the basis of the results of the consistent clinical studies analyzed in this review, we try to design a randomized clinical trial aimed at evaluating the effects of a reasoned multitarget therapeutic strategy on the prevention of post-STEMI LVR. In fact, we believe that the correct timing of pharmacological and mechanical intervention application, according to their specific ability to interfere with survival pathways, may significantly reduce the incidence of post-STEMI LVR and thus improve patient prognosis.<\/jats:p>","DOI":"10.3390\/jcm10132968","type":"journal-article","created":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T12:03:27Z","timestamp":1625141007000},"page":"2968","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Reducing Cardiac Injury during ST-Elevation Myocardial Infarction: A Reasoned Approach to a Multitarget Therapeutic Strategy"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3476-5696","authenticated-orcid":false,"given":"Alessandro","family":"Bellis","sequence":"first","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Cardiologia con UTIC ed Emodinamica\u2014Dipartimento Emergenza Accettazione, Azienda Ospedaliera \u201cAntonio Cardarelli\u201d, Via A. Cardarelli n. 9, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3297-8399","authenticated-orcid":false,"given":"Giuseppe","family":"Di Gioia","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratory, Montevergine Clinic, Via M. Malzoni, 83013 Mercogliano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Mauro","sequence":"additional","affiliation":[{"name":"Unit\u00e0 Operativa Complessa Cardiologia con UTIC ed Emodinamica\u2014Dipartimento Emergenza Accettazione, Azienda Ospedaliera \u201cAntonio Cardarelli\u201d, Via A. Cardarelli n. 9, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6690-1408","authenticated-orcid":false,"given":"Costantino","family":"Mancusi","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 FEDERICO II, Via S. Pansini n. 5, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Barbato","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 FEDERICO II, Via S. Pansini n. 5, 80131 Napoli, Italy"},{"name":"Cardiovascular Center Aalst, OLV Clinic, 9300 Aalst, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Izzo","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 FEDERICO II, Via S. Pansini n. 5, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0701-6449","authenticated-orcid":false,"given":"Bruno","family":"Trimarco","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 FEDERICO II, Via S. Pansini n. 5, 80131 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2158-6317","authenticated-orcid":false,"given":"Carmine","family":"Morisco","sequence":"additional","affiliation":[{"name":"Dipartimento di Scienze Biomediche Avanzate, Universit\u00e0 FEDERICO II, Via S. 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