Emerging role of melatonin in the alleviation of ischemic heart disease: A comprehensive review

Melatonin, a circardian biomolecule exerts cardioprotective effects through its ability to directly scavenge free radicals and to indirectly act as an antioxidant. It has biological functions such as anti-apoptosis, anti-inflammation, antioxidant activity, mitochondrial protection, and controlling the production of cytokines by target cells. Melatonin also showed blood pressure lowering, normalising lipid profiles, and anti-inflammatory characteristics. Melatonin plays critical roles in averting oxidative stress, enhancing autophagic cell repair, modulating immunological and inflammatory responses, improving mitochondrial function, and reducing endoplasmic reticulum stress in cardiomyocytes. The absence of these cardioprotective properties due to low melatonin levels may be linked to an array of cardiovascular diseases, including ischemic heart disease. As a result, administration of melatonin is anticipated to have a clinically important role in the management of ischemic heart disease; an assertion backed by melatonin's low toxicity and high safety. Therefore, the evidence gathered in this review should provide comprehensive information on melatonin's effect in cardioprotection and, perhaps, contribute to the planning of future experimental studies.