Acute myocardial infarction (MI) is a major cause of mortality and disability worldwide. In patients with MI, the treatment option for reducing acute myocardial ischemic injury and limiting MI size is timely and effective myocardial reperfusion using either thombolytic therapy or primary percutaneous coronary intervention (PCI). However, the procedure of reperfusion itself induces cardiomyocyte death, known as myocardial reperfusion injury, for which there is still no effective therapy. Recent evidence has depicted a promising role of melatonin, which possesses powerful antioxidative and anti‐inflammatory properties, in the prevention of ischemia‐reperfusion (IR) injury and the protection against cardiomyocyte death. A number of reports explored the mechanism of action behind melatonin‐induced beneficial effects against myocardial IR injury. In this review, we summarize the research progress related to IR injury and discuss the unique actions of melatonin as a protective agent. Furthermore, the possible mechanisms responsible for the myocardial benefits of melatonin against reperfusion injury are listed with the prospect of the use of melatonin in clinical application.

中文翻译：

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褪黑素在心脏缺血再灌注损伤中的保护作用：从发病机理到靶向治疗

急性心肌梗塞（MI）是全球范围内死亡和残疾的主要原因。对于心梗患者，使用溶栓治疗或一次经皮冠状动脉介入治疗（PCI）可以及时有效地减少心肌急性缺血损伤并限制心梗大小，这是治疗的选择。但是，再灌注过程本身会引起心肌细胞死亡，称为心肌再灌注损伤，目前尚无有效的治疗方法。最近的证据表明褪黑素在预防缺血再灌注（IR）损伤和防止心肌细胞死亡方面具有令人鼓舞的作用，它具有强大的抗氧化和抗炎特性。许多报告探讨了褪黑素诱导的抗心肌IR损伤的有益作用的作用机制。在这篇综述中，我们总结了与IR损伤有关的研究进展，并讨论了褪黑激素作为保护剂的独特作用。此外，列出了褪黑激素对抗再灌注损伤对心肌有益的可能机制，并有望在临床应用中使用褪黑激素。