Coronary microvascular obstruction in acute myocardial infarction

Giampaolo Niccoli, Giancarla Scalone, Amir Lerman, Filippo Crea

Research output: Contribution to journalArticle

137 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1024-1033
Number of pages10
JournalEuropean Heart Journal
Volume37
Issue number13
DOIs
StatePublished - Apr 1 2016

Keywords

  • Acute myocardial infarction
  • Microvascular dysfunction
  • Microvascular obstruction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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