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The occlusion was maintained to prevent reperfusion of the at-risk area
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Carnitine depletion and OCTN2 inhibition In addition to inhibiting carnitine synthesis, Meldonium inhibits the organic cation/carnitine transporter OCTN2 (SLC22A5), which mediates cellular uptake and renal reabsorption of carnitine ( -oxidation in skeletal and cardiac muscle, shifting ATP production toward carbohydrate oxidation and glycolysis ( Substrate shift under hypoxia/ischemia By constraining fatty-acid -oxidation, Meldonium promotes a greater reliance on glucose-derived acetyl-CoA and oxaloacetate, supporting continued flux through glycolysis and the Krebs (TCA) cycle
