TY - JOUR
T1 - Coronary microvascular obstruction in acute myocardial infarction
AU - Niccoli, Giampaolo
AU - Scalone, Giancarla
AU - Lerman, Amir
AU - Crea, Filippo
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Acute myocardial infarction
KW - Microvascular dysfunction
KW - Microvascular obstruction
KW - Acute myocardial infarction
KW - Microvascular dysfunction
KW - Microvascular obstruction
UR - http://hdl.handle.net/10807/73959
U2 - 10.1093/eurheartj/ehv484
DO - 10.1093/eurheartj/ehv484
M3 - Article
SN - 0195-668X
VL - 37
SP - 1024
EP - 1033
JO - European Heart Journal
JF - European Heart Journal
ER -