Targeting Programmed Cell Death in Myocardial Ischemia–Reperfusion Injury: Potential Mechanisms and Natural Medicine Treatments

Acute myocardial infarction (AMI) is a serious threat to human life and health, being one of the leading causes of death and disability worldwide. Reperfusion therapy with prompt restoration of blood flow supply is currently the most effective method to save ischemic myocardium, which can significantly improve patient prognosis and reduce mortality. However, the sudden restoration of blood flow can cause additional myocardial damage, known as myocardial ischemia-reperfusion injury (MIRI). Myocardial cell death is the underlying pathology of irreversible cardiac injury, and reducing myocardial cell loss may be a potential therapy for MIRI. Programmed cell death (PCD), which encompasses apoptosis, autophagy, necroptosis, pyroptosis, and ferroptosis, has been demonstrated to be involved in the pathological process of MIRI. Studies have shown that natural medicine can treat MIRI by modulating PCD with a wide range of sources, significant effects, and fewer side effects, thereby emerging as a promising complementary and alternative therapy. This article outlines the roles of various PCDs in the pathogenesis of MIRI and summarizes the role and potential mechanisms of natural medicine targeting PCD for the treatment of MIRI, to provide reference for in-depth research and new drug development.