EDITORIAL Mitochondrial care in acutemyocardial infarction

This editorial refers to ‘Effect of intravenous TRO40303 as an adjunct to primary percutaneous coronary inter-vention for acute ST-elevation myocardial infarction: the MITOCARE study results’†, by D. Atar et al. on page 112 Rapid restoration of blood flow has the greatest impact on reducing infarct size and improving patient prognosis in patients with ST-elevation myocardial infarction (MI). However, reperfusion itself can exacerbate myocardial damage on top of the initial ischae-mic damage.1 Lethal reperfusion injury develops when sudden res-toration of blood flow causes necrosis of myocytes that—albeit injured by the preceding ischaemia—were potentially salvageable at the time of reperfusion. In animal models, reperfusion injury may account for up to 50 % of the final infarct size.1 Reperfusion injury is modifiable. Pre-infarct angina and repetitive episodes of ischaemia before ST-elevation MI reduce final infarc