Lizard Spit and Reperfusion Injury

Although the incidence of ST-segment elevation myocardial infarction (STEMI) is declining in industrialized nations, there are still an estimated 500,000 events annually in the U. S. (1). Furthermore, the in-hospital mortality is 6% to 7%, and over 15% of survivors to discharge experience a recurrent cardiovascular event by 6 months (2). Infarct size is the key determinant of outcome, and prompt reperfusion of the occluded epicardial artery is imperative to reduce infarction volume and improve mortality and morbidity. Paradoxically, however, reperfusion seems to contribute to additional myocardial damage over and above that caused by the original ischemic insult. This additional damage is known as reperfusion injury and if it could be prevented an already exemplary treatment would be further improved.