Assessing and managing coronary microcirculation dysfunction in acute ST segment elevation myocardial infarction.

Assessing and managing coronary microcirculation dysfunction in acute ST segment elevation myocardial infarction. Expert Rev Cardiovasc Ther. 2018 Dec 20;: Authors: Armstrong R, De Maria GL, Scarsini R, Banning AP Abstract INTRODUCTION: Microvascular dysfunction in the setting of acute ST segment elevation myocardial infarction (STEMI) is an indicator of poor long-term prognosis. Prompt assessment and pharmacological or procedural therapy (prophylactic or post onset of dysfunction) may improve outcomes in STEMI post primary percutaneous intervention. Areas covered: The aim of this review is to provide a comprehensive analysis of the evidence available about the assessment and management of coronary microcirculatory injury/dysfunction in STEMI. We also aim to elucidate the possible strategies that could be applied in clinical practice to support the application of already available or novel therapeutic strategies for the prevention and management of microvascular impairment. Expert commentary: There are multiple established methods in assessing microvascular dysfunction, both non-invasively and invasively. Invasive physiological measurements allow real-time assessment of microvascular dysfunction and have prognostic cut-off values. Multiple therapeutic modalities exist for both preventing and treating microvascular dysfunction. These can be either pharmacological or mechanical, and there is no algorithm to guide if, how and when to ap...
Source: Expert Review of Cardiovascular Therapy - Category: Cardiology Tags: Expert Rev Cardiovasc Ther Source Type: research