Abstract: The inventors have made the surprising discovery that when ceramide production is upregulated in the infarct and at-risk areas upon reperfusion injury in the heart, such upregulation is effected through the de novo ceramide synthesis pathway. Upon treatment of cardiac tissues subject to reperfusion injury with a specific inhibitor of the novo ceramide synthesis pathway (myriocin), the inventors have determined that the inhibition of such pathway not only reduces the inflammation of the interested area, but most surprisingly reduces infarct size, ameliorates cardiac contractility and activates cell detoxification and survival programs. There is thus provided an inhibitor of de novo ceramide synthesis pathway, particularly myriocin, for the treatment of cardiac reperfusion injury.