Figure 4.

Scheme for a reasoned multitarget therapeutic strategy against post-STEMI LVR in the ‘post-pPCI’ phase. In this picture, the timing of conventional pharmacological therapy for STEMI patients, in the ‘post-pPCI’ phase is described, according to the European Society of Cardiology (ESC) guidelines. Each pharmacological indication is identified with its own class of recommendation and level of evidence. In the gray rectangles, the perspective pharmacological therapies (ARNI, liraglutide, glifozins) and mechanical interventions (RIPost-C) in order to further improve protection against post-STEMI LVR according to precise timing are identified. STEMI: ST elevation myocardial infarction; pPCI: primary percutaneous intervention; LVR: left ventricular remodeling; ARNI: angiotensin receptor neprilysin inhibitor; RIPost-C: remote ischemic post-conditioning; PCSK9: proprotein convertase subtilisin/kexin type 9; ARBs: angiotensin receptor blockers; MRAs: mineralocorticoid receptor antagonists; DAPT: dual anti-platelet therapy; ASA: acetylsalicylic acid; LVEF: left ventricular ejection fraction.