Inflammatory Signaling Pathways and Non-Coding RNAs in Myocardial Infarction: Insights into Pathogenesis and Therapeutic Opportunities

Acute myocardial infarction (AMI) is a major contributor to both morbidity and mortality, resulting from the abrupt blockage of a coronary artery. Myocardial reperfusion refers to the re-establishment of coronary blood flow following a period of coronary occlusion, which may provoke an intensified and rapid injury to the myocardium, known as ischemia-reperfusion (I/R) injury. Inflammation is a key feature of myocardial infarction (MI) and ischemia/reperfusion (MI/R) injury, playing a central role among the pathological mechanisms involved in AMI and MI/R injury. Non-coding RNAs (ncRNAs), such as miRNAs, lncRNAs, and circRNAs, constitute a significant portion of the transcribed genome, with their essential roles and potential in regulating and resolving inflammation now well established. Abnormal ncRNA expression has been linked to the worsening of inflammatory processes and plays a role in the pathogenesis of MI and MI/R injury. This study emphasizes the essential roles played by miRNAs and competitive endogenous RNAs (ceRNAs) in the progression of MI and MI/R. In addition, our final section provides an in-depth analysis of the therapeutic targeting of ncRNAs through a variety of methods, including pharmacological interventions, herbal medicine, and exosome-derived stem cell applications, aimed at alleviating inflammation and possibly advancing MI treatment.