What are the mechanisms of ischemia-independent mechanisms contributing to the infarct size in patients with acute myocardial infarction?
Infarct size is the single most important prognostic factor for short- and long-term outcomes.
The success in reperfusion strategies have shown that prompt reperfusion leads to a reduction in infarct size, and to improved outcomes.
Despite effective reperfusion, however, a secondary wave of ischemia-independent injury appears to occur. This is often referred to "reperfusion injury" and includes mitochondrial injury, microvascular obstruction, and inflammatory injury.
Adjunct therapies to reduce ischemia-independent injury have failed. This may reflect a gap in our understanding of the process.