Quercetin-associated cardioprotection in preclinical myocardial ischemia-reperfusion injury: a systematic review and meta-analysis
Abstract
Background and objective Prompt reperfusion is the standard treatment for acute myocardial infarction, but it can induce myocardial ischemia-reperfusion injury (MIRI). Quercetin, a plant-derived flavonoid, has been investigated as a potential cardioprotective agent in preclinical MIRI models; however, its effect magnitude, dose-exposure relevance, and mechanistic specificity remain uncertain. This systematic review and meta-analysis evaluated quercetin monotherapy in vivo and ex vivo MIRI models. Methods Databases were searched from inception to March 2026 for controlled preclinical studies comparing quercetin monotherapy with vehicle-treated MIRI controls. The primary endpoint was myocardial infarct size. Secondary outcomes included myocardial injury biomarkers, hemodynamic recovery, oxidative-stress markers, and inflammatory cytokines. Random-effects models calculated standardized mean differences (SMDs) or mean differences (MDs). Subgroup, leave-one-out, split-control, risk-of-bias-informed, dose-response meta-regression, and publication-bias analyses were performed where feasible. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD420261325366). Results Twenty studies were included. Quercetin was associated with reduced infarct size compared with vehicle controls (SMD = −2.98, 95% confidence interval −4.37 to −1.58; P < 0.00001). A split-control sensitivity analysis showed an attenuated but directionally consistent…
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Evidence Hub reads this as a meta-analysis, done in animal, not in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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