Despite a timely and generalised use of angioplasty in acute myocardial infarction (AMI), reperfusion injury (RI) and uncontrolled fibrosis result in cardiac damage. This project aims to advance in mechanisms, diagnosis, prediction and prevention of the cardiac damage associated with AMI. A group of basic and clinical investigators and a high-tech company (ERESA) will participate. The research will be carried out in a prospective series of myocardial infarction (STEMI) patients studied with cardiac magnetic resonance imaging (MRI) and in experimental models of induced AMI. The objectives are the following. 1) Basic Mechanisms: 1.1) Oxidative Stress: focus on xanthine oxidoreductase (XOR) and its forms; 1.2) neoangiogenesis: focus on vascular endothelial growth factor A165b (VEGF-A165b). 2) Diagnosis with New MRI Tools: 2.1) Using magnetic resonance (MR) micro-imaging of swine myocardial samples, novel MRI contrast-free sequence combinations will be defined. (2.2) Innovative MRI tools based on the study of myocardial textures will be developed; 2.3) Feature tracking MRI (FT-MRI) will be applied to offline cine images to assess cardiac damage and myocardial strain. 3) Prediction with Novel Biomarkers: 3.1) Using nuclear magnetic resonance spectroscopy, novel and robust metabolic biosignatures will be constructed in swine and then optimised and validated in STEMI patients to achieve an immediate and personalised Prognostication of the extent of cardiac damage and of functional outcome; 3.2) The combined values of CA125, galectine-1 and -3 will be determined. 4) Prevention: 4.1) An antioxidant approach to prevent RI (oxypurinol and cyclosporine A), locally administered into the area at risk upon reperfusion using an ischemic post-conditioning protocol; 4.2) The effect of chronic antioxidant therapy to prevent systolic deterioration, remote fibrosis and inducibility of ventricular arrhythmias will be explored in a rabbit model of chronic infarction.