Moreover, other authors have speculated that there is a dual-effect of MIF release following an AMI [6], suggesting that an early rise of cardiac-derived MIF (first MIF wave) might be responsible for exerting cardioprotection in the setting of a brief ischemia, followed by an activation of circulating leukocytes under longer ischemic insults, resulting in an increased expression of MIF (second MIF wave) and other inflammatory molecules, that enhance deleterious inflammatory responses [29]. Here, MIF is linked to ischemia.