Coronary Microvascular Obstruction and Dysfunction in Patients with Acute Myocardial Infarction

Overview

Journal Nat Rev Cardiol

Specialty Cardiology & Vascular Diseases

Date 2023 Nov 24

PMID 38001231

Authors

Mattia Galli

Giampaolo Niccoli

Gianluigi De Maria

Salvatore Brugaletta

Rocco A Montone

Rocco Vergallo

Stefano Benenati

Giulia Magnani

Domenico DAmario

Italo Porto

Francesco Burzotta

Antonio Abbate

Dominick J Angiolillo

Filippo Crea

Affiliations

Soon will be listed here.

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.

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