It has been recognized that oxidative stress plays a key role in the
development of cardiac alterations derived from events of ischemia followed by
reperfusion, such as in the clinical setting of acute myocardial infarction of patients
subjected to coronary angioplasty. During ischemia, due to the occlusion of a coronary
branch, biochemical events responsible for anaerobic metabolism, ATP availability and
impairment of cell ionic homeostasis are the major deleterious effects. Following the
onset of reperfusión, a burst of reactive oxygen species occurs, thus accounting for
increased tissue damage due to the endovascular intervention. This iatrogenic damage
has not been adequately treated to date. Among the many pharmacological attempts,
cardioprotection with antioxidants should be mentioned; however, the experimental
studies have not been translated into successful clinical trials aimed to prevent this
enhancement of cardiac damage, despite some beneficial effects have been reported in
the clinical outcome of the patients. This chapter aimed to present the hypothesis that
the combination of antioxidant effects should improve the cardioprotection of the
patients subjected to coronary angioplasty following acute myocardial infarction.
Therefore, we present an update of previous attempts at cardioprotection with an
antioxidant alone and give the basis for the expected improved protection by using two
or more antioxidant compounds exerting different mechanisms that could enhance the
beneficial protective effect.
Keywords: Acute myocardial infarction, Antioxidant enzymes, Antioxidants, Apoptosis, Combined antioxidant treatment, Ischemia/Reperfusion injury, Lipid peroxidation, Necrosis, Oxidative stress, Reactive oxygen species.
