Histone Deacetylase Inhibitors as a Promising Treatment Against Myocardial Infarction: A Systematic Review.

Area of Science:

• Cardiovascular Research
• Pharmacology
• Molecular Biology

Background:

• Acute myocardial infarction (AMI) necessitates rapid intervention to minimize cardiac damage and improve survival.
• Ischaemia/reperfusion (I/R) injury complicates AMI treatment, highlighting the urgent need for novel therapeutic strategies.
• Histone deacetylase (HDAC) inhibitors are emerging as a potential treatment for myocardial infarction.

Purpose of the Study:

• To systematically review the effects of HDAC inhibitors on ventricular function, cardiac remodelling, and infarct size in AMI.
• To identify signalling pathways mediating the cardioprotective effects of HDAC inhibitors against AMI.
• To assess the potential of HDAC inhibitors as a therapeutic strategy for AMI and I/R injury.

Main Methods:

• Systematic review of original experimental studies on HDAC inhibitors and AMI.
• Inclusion of studies from PubMed and Scopus databases; exclusion of non-experimental papers.
• Risk of bias assessment using the SYRCLE RoB tool and results summarized by HDAC inhibitor type.

Main Results:

• 18 studies included; 10 used trichostatin A (TSA), showing improved ventricular function, reduced infarct size, and inhibited hypertrophy/remodelling.
• Other HDAC inhibitors (SAHA, VPA, etc.) demonstrated antioxidant, anti-inflammatory, improved cardiac function, and reduced apoptosis.
• Consistent evidence of cardioprotective effects across various HDAC inhibitors studied.

Conclusions:

• HDAC inhibitors offer significant promise for treating AMI due to their diverse cardioprotective actions.
• High risk of bias in current in vivo studies limits immediate clinical application.
• More research is essential to fully understand the benefits, side effects, and clinical utility of HDAC inhibitors for AMI.