EDITORIAL Taking lizard saliva to heart

This editorial refers to ‘Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction’†, by J. Lønborg et al., on page 1491 For patients presenting with an acute ST-segment elevation myocardial infarction (STEMI), the most effective therapy for reducing myocardial infarct (MI) size, preserving left ventricular (LV) systolic function, and improving clinical outcomes is timely myocardial reperfusion by primary percutaneous coronary intervention (PPCI). Although the process of myocardial reperfu-sion is critical for myocardial salvage, paradoxically it can also induce cardiomyocyte death, thereby mitigating the full beneficial effects of myocardial reperfusion in terms of MI size reduction and myocardial salvage—a phenomenon which has been termed ‘lethal myocardial reperfusion injury’.1 The fact that a therapeutic intervention administered solely at the time of myo