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Background Myocardial ischemia/reperfusion injury (MI/RI) during myocardial infarction worsens out-comes. It has been proved that ginsenoside Rb1 has a great impact on ischemia/reperfusion(I/R)injury. The aim of this study is to explore the protective effect of the pretreatment with ginsenoside Rb1 on MI/RI and investigate the underlying mechanisms about the preventive action. Methods A total of 27 healthy adult Sprague-Dawley (SD)rats were randomly divided into 3 groups(n=9 per group):A sham-operated group(Sham n=9);an isch-emia 40 min/reperfusion 2 h(I/R n=9)of the cardiac muscle group;Rb1-treated group was divided into 3 sub-groups(Rb110 mg/kg,20 mg/kg,40 mg/kg,n=3). Ginsenosides Rb1 at different concentrations were injected intraperitoneally for 3 days continuously before ligation. A model of MI/RI was constructed by ligation of the left coronary artery anterior descending branch in rats. Myocardial infarction area after I/R was measured bytriphenyl-tetrazolium chloride(TTC)staining of myocardial tissue. Hematoxylin and eosin(HE)staining and electrocar-diogram indication were used to observe myocardial cell injury and ischemia,respectively. The expression of caspase-8 protein was observed by immunohistochemistry staining. Results The pretreatment of 40 mg/kg dose of ginsenoside Rb1 could decrease the expression of caspase-8 protein caused by I/R and the apoptosis of myocardial cells,improve myocardial ischemia,reduce the area of myocardial infarction and ameliorate MI/RI. Conclusions These results demonstrate that ginsenoside Rb1 has a significant protective effect on MI/RI through attenuating the apoptosis of myocardial cells and improving myocardial ischemia at appropriate dose, which provides new insights into the potential therapy of MI/RI.