Perspective Chapter: Immunotherapy for Myocardial Infarction

Myocardial infarction (MI) remains a leading cause of morbidity and mortality worldwide. While timely reperfusion reduces acute mortality, many patients still progress to adverse remodeling, arrhythmias, and chronic heart failure. Increasing evidence shows that post-MI immune responses play a dual role, essential for tissue repair yet harmful when excessive or unresolved. This has shifted therapeutic strategies from broad anti-inflammatory approaches to precision immunomodulation tailored to disease stage and immune cell dynamics. Emerging clinical studies and experimental therapies, including targeted cytokine blockade, adoptive immune cell transfer, engineered cellular therapies, and advanced drug delivery systems – demonstrate the potential to reshape the immune microenvironment and improve long-term outcomes. However, challenges remain in identifying optimal treatment windows, ensuring safety, and translating complex therapies into routine practice. Overall, immunotherapy represents a promising complement to conventional reperfusion, offering a path toward more precise and durable management of MI.