1. Coronary microvascular obstruction and dysfunction in patients with acute myocardial infarction.
- Author
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Galli M, Niccoli G, De Maria G, Brugaletta S, Montone RA, Vergallo R, Benenati S, Magnani G, D'Amario D, Porto I, Burzotta F, Abbate A, Angiolillo DJ, and Crea F
- Subjects
- Humans, Coronary Circulation physiology, Prognosis, Microcirculation physiology, ST Elevation Myocardial Infarction complications, ST Elevation Myocardial Infarction diagnosis, ST Elevation Myocardial Infarction therapy, Percutaneous Coronary Intervention adverse effects, Myocardial Infarction complications, Myocardial Infarction therapy
- Abstract
Despite prompt epicardial recanalization in patients presenting with ST-segment elevation myocardial infarction (STEMI), coronary microvascular obstruction and dysfunction (CMVO) is still fairly common and is associated with poor prognosis. Various pharmacological and mechanical strategies to treat CMVO have been proposed, but the positive results reported in preclinical and small proof-of-concept studies have not translated into benefits in large clinical trials conducted in the modern treatment setting of patients with STEMI. Therefore, the optimal management of these patients remains a topic of debate. In this Review, we appraise the pathophysiological mechanisms of CMVO, explore the evidence and provide future perspectives on strategies to be implemented to reduce the incidence of CMVO and improve prognosis in patients with STEMI., (© 2023. Springer Nature Limited.)
- Published
- 2024
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