In rats with acute myocardial ischemia–reperfusion injury, high plasma Hcy levels have been shown to trigger mitochondrial dysfunction, potentially through increased cytochrome c release, enhanced reactive oxygen species (ROS) production, and extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway activation, leading to cardiac impairment [49]. Here, MAPK3 is linked to myocardial ischemia.