The success of a primary percutaneous intervention (PCI) in the setting of ST elevation myocardial infarction depends on the functional and structural integrity of coronary microcirculation. Coronary microvascular dysfunction and obstruction (CMVO) occurs in up to half of patients submitted to apparently successful primary PCI and is associated to a much worse outcome. The current review summarizes the complex mechanisms responsible for CMVO, including pre-existing coronary microvascular dysfunction, and highlights the current limitations in the assessment of microvascular function. More importantly, at the light of the substantial failure of trials hitherto published on the treatment of CMVO, this review proposes a novel integrated therapeutic approach, which should overcome the limitations of previous studies.

Niccoli, G., Scalone, G., Lerman, A., Crea, F., Coronary microvascular obstruction in acute myocardial infarction, <<EUROPEAN HEART JOURNAL>>, 2016; 37 (13): 1024-1033. [doi:10.1093/eurheartj/ehv484] [http://hdl.handle.net/10807/73959]

Coronary microvascular obstruction in acute myocardial infarction

Niccoli, Giampaolo
Primo
;
Scalone, Giancarla
Secondo
;
Crea, Filippo
Ultimo
2016

Abstract

The success of a primary percutaneous intervention (PCI) in the setting of ST elevation myocardial infarction depends on the functional and structural integrity of coronary microcirculation. Coronary microvascular dysfunction and obstruction (CMVO) occurs in up to half of patients submitted to apparently successful primary PCI and is associated to a much worse outcome. The current review summarizes the complex mechanisms responsible for CMVO, including pre-existing coronary microvascular dysfunction, and highlights the current limitations in the assessment of microvascular function. More importantly, at the light of the substantial failure of trials hitherto published on the treatment of CMVO, this review proposes a novel integrated therapeutic approach, which should overcome the limitations of previous studies.
2016
Inglese
10.1093/eurheartj/ehv484. Epub 2015 Sep 12.
Niccoli, G., Scalone, G., Lerman, A., Crea, F., Coronary microvascular obstruction in acute myocardial infarction, <<EUROPEAN HEART JOURNAL>>, 2016; 37 (13): 1024-1033. [doi:10.1093/eurheartj/ehv484] [http://hdl.handle.net/10807/73959]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/73959
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