Department of Pharmacy Practice, Srinivas College of Pharmacy, Manglore-574143.
Cardiovascular disease (CVD) remains a global health concern, accounting for a significant portion of annual deaths. Myocardial infarction (MI) and ischemic stroke contribute substantially to CVD-related mortality. Despite decades of research, cardiac repair post-MI remains challenging. The immune system's pivotal role in the aftermath of MI initiates inflammation crucial for tissue healing, yet excessive inflammation may hinder left ventricle remodeling, leading to heart failure. This comprehensive systematic review explores the pathophysiology of MI, emphasizing the importance of understanding coronary artery occlusion-induced myocardial necrosis and subsequent healing processes. The clinical manifestations of MI, including ST-segment elevation and non-ST-segment elevation scenarios, are delineated alongside risk factors, genetic predispositions, and variable symptomatology. First-line treatments, such as oxygen therapy, nitroglycerin, and reperfusion therapy, are examined. The efficacy and safety of oxygen therapy are scrutinized, challenging its routine use. Nitroglycerin, once contraindicated, is reassessed, particularly in specific MI subgroups. Reperfusion therapy, while reducing mortality, poses risks, prompting exploration into device-based therapies to mitigate side effects. Antiplatelet therapy, including aspirin and P2Y12 inhibitors, assumes a critical role in MI treatment. Aspirin's controversial role in primary prevention is juxtaposed with its established benefits in secondary prevention. Beta-blockers, long recommended post-MI, exhibit varied outcomes in contemporary patient populations, necessitating further research. The review delves into the pivotal roles of anticoagulants, statins, and ACE inhibitors/ARBs in preventing recurrent events post-MI. Personalized medicine emerges as a key consideration in tailoring treatment plans to individual patient characteristics.
Satish S., Aravind Babu C.*, Advancements In Pharmacotherapy For Myocardial Infarction: A Comprehensive Review, Int. J. in Pharm. Sci., 2023, Vol 1, Issue 12, 534-542. https://doi.org/10.5281/zenodo.10405404
10.5281/zenodo.10405404
