The main goal of the treatment for acute myocardial infarction is to achieve reperfusion of the affected myocardial tissue, with percutaneous coronary angioplasty being the gold standard procedure. However, this strategy has been associated with additional heart damage termed “lethal reperfusion injury,” which is responsible for up to half of the final infarct size. Among the possible underlying mechanisms that are likely to explain this damage, studies suggest that oxidative stress plays a key role. Although this has not been translated into clinical benefits in most studies, recent preclinical studies reported promising results and a possible synergy with the combined use of vitamin C (VC), N-acetylcysteine (NAC), and deferoxamine (DFO). However, to implement a combined therapy with these drugs for patients requires further studies to understand their pharmacokinetic properties. Available data of the clinical trials have not been validated by looking into the pharmacokinetics in their design. Therefore, this article presents an update and comparison of the evidence for the efficacy of these administration schemes for each drug in cardioprotection, their pharmacokinetic properties and mechanisms of action for their use against “lethal reperfusion injury.” To achieve a cardioprotective effect using a new pharmacological strategy before the onset of reperfusion, it is helpful to consider the pharmacokinetics of each drug. In this regard, to design a fast and short pharmacologic therapeutic strategy, theoretically VC and DFO concentrations could be modeled by a one-compartment model whereas NAC could be modeled by a three-compartment model with an initial short half-life.

急性心肌梗死治疗的主要目标是实现受影响心肌组织的再灌注，经皮冠状动脉成形术是金标准程序。然而，这种策略与称为“致死性再灌注损伤”的额外心脏损伤有关，该损伤占最终梗塞面积的一半。在可能解释这种损害的潜在机制中，研究表明氧化应激起着关键作用。尽管这在大多数研究中尚未转化为临床益处，但最近的临床前研究报告了有希望的结果以及与维生素 C (VC)、N-乙酰半胱氨酸（NAC）和去铁胺（DFO）。然而，要对患者实施与这些药物的联合治疗，需要进一步研究以了解它们的药代动力学特性。临床试验的可用数据尚未通过研究其设计中的药代动力学得到验证。因此，本文对这些给药方案对每种药物在心脏保护方面的功效、药代动力学特性和针对“致死性再灌注损伤”的作用机制的证据进行了更新和比较。为了在再灌注开始之前使用新的药理学策略实现心脏保护作用，考虑每种药物的药代动力学是有帮助的。在这方面，设计一个快速和短期的药物治疗策略，