AKT1 and Hyperglycemia: It is believed that propofol reduces endothelial cell damage and suppresses myocardial autophagy in diabetic MI/R injury.[21,22] Furthermore, several studies have demonstrated that propofol postconditioning inhibits miR-200c-3p, upregulates AdipoR2, and activates the STAT3 signaling pathway.[23] Pretreating dexmedetomidine may confer cardioprotective effects by activating Akt, inducing GSK-3β phosphorylation, and reducing endoplasmic reticulum stress-induced cardiomyocyte apoptosis.[24–27] Among opioid agonists, hyperglycemia attenuates the cardioprotective effects of remifentanil.