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Microvascular Obstruction in Acute Myocardial Infarction, a Potential Therapeutic Target

Lookup NU author(s): Dr Mina Ghobrial, Dr Bilal Bawamia, Professor Ioakim SpyridopoulosORCiD, Professor Vijay KunadianORCiD, Professor Azfar ZamanORCiD, Dr MOHANED Egred, Dr Adam McDiarmid, Dr Mohammad Alkhalil

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2023 by the authors. Microvascular obstruction (MVO) is a recognised phenomenon following mechanical reperfusion in patients presenting with ST-segment elevation myocardial infarction (STEMI). Invasive and non-invasive modalities to detect and measure the extent of MVO vary in their accuracy, suggesting that this phenomenon may reflect a spectrum of pathophysiological changes at the level of coronary microcirculation. The importance of detecting MVO lies in the observation that its presence adds incremental risk to patients following STEMI treatment. This increased risk is associated with adverse cardiac remodelling seen on cardiac imaging, increased infarct size, and worse patient outcomes. This review provides an outline of the pathophysiology, clinical implications, and prognosis of MVO in STEMI. It describes historic and novel pharmacological and non-pharmacological therapies to address this phenomenon in conjunction with primary PCI.

Publication metadata

Author(s): Ghobrial M, Bawamia B, Cartlidge T, Spyridopoulos I, Kunadian V, Zaman A, Egred M, McDiarmid A, Williams M, Farag M, Alkhalil M

Publication type: Review

Publication status: Published

Journal: Journal of Clinical Medicine

Year: 2023

Volume: 12

Issue: 18

Online publication date: 13/09/2023

Acceptance date: 09/09/2023

ISSN (electronic): 2077-0383

Publisher: MDPI

URL: https://doi.org/10.3390/jcm12185934

DOI: 10.3390/jcm12185934

Data Access Statement: Not applicable.

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