Coronary microvascular obstruction in acute myocardial infarction

Filippo Crea, Giampaolo Niccoli, Giancarla Scalone, Amir Lerman

Research output: Contribution to journalArticlepeer-review

173 Citations (Scopus)


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.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalEuropean Heart Journal
Publication statusPublished - 2015


  • Acute myocardial infarction
  • Microvascular dysfunction
  • Microvascular obstruction


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