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Novel device-based therapies to improve outcome in ST-segment elevation myocardial infarction

Title: Novel device-based therapies to improve outcome in ST-segment elevation myocardial infarction
Authors: Giovanni Luigi De Maria; Hector M Garcia-Garcia; Roberto Scarsini; Aloke Finn; Yu Sato; Renu Virmani; Ravinay Bhindi; Jonathan L Ciofani; Jorge Nuche; Henrique B Ribeiro; Wilson Mathias; Charan Yerasi; Tim A Fischell; Luuk Otterspoor; Flavio Ribichini; Borja Ibañez; Nico H J Pijls; Robert S Schwartz; Navin K Kapur; Gregg W Stone; Adrian P Banning
Contributors: Luigi De Maria, Giovanni; M Garcia-Garcia, Hector; Scarsini, Roberto; Finn, Aloke; Sato, Yu; Virmani, Renu; Bhindi, Ravinay; L Ciofani, Jonathan; Nuche, Jorge; B Ribeiro, Henrique; Mathias, Wilson; Yerasi, Charan; A Fischell, Tim; Otterspoor, Luuk; Ribichini, Flavio Luciano; Ibañez, Borja; J Pijls, Nico H; S Schwartz, Robert; K Kapur, Navin; W Stone, Gregg; P Banning, Adrian
Publication Year: 2021
Collection: Università degli Studi di Verona: Catalogo dei Prodotti della Ricerca (IRIS)
Subject Terms: ST-elevation myocardial infarction; Infarct size; Microvascular injury; Ischaemia-reperfusion injury; Device-based therapies
Description: Primary percutaneous coronary intervention (PPCI) has dramatically changed the outcome of patients with ST-elevation myocardial infarction (STEMI). However, despite improvements in interventional technology, registry data show little recent change in the prognosis of patients who survive STEMI, with a significant incidence of cardiogenic shock, heart failure, and cardiac death. Despite a technically successful PPCI procedure, a variable proportion of patients experience suboptimal myocardial reperfusion. Large infarct size and coronary microvascular injury, as the consequence of ischaemia-reperfusion injury and distal embolization of atherothrombotic debris, account for suboptimal long-term prognosis of STEMI patients. In order to address this unmet therapeutic need, a broad-range of device-based treatments has been developed. These device-based therapies can be categorized according to the pathophysiological pathways they target: (i) techniques to prevent distal atherothrombotic embolization, (ii) techniques to prevent or mitigate ischaemia/reperfusion injury, and (iii) techniques to enhance coronary microvascular function/integrity. This review is an overview of these novel technologies with a focus on their pathophysiological background, procedural details, available evidence, and with a critical perspective about their potential future implementation in the clinical care of STEMI patients.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/wos/WOS:000703964000015; volume:10; issue:6; firstpage:687; lastpage:697; numberofpages:11; journal:EUROPEAN HEART JOURNAL. ACUTE CARDIOVASCULAR CARE; https://hdl.handle.net/11562/1072189
DOI: 10.1093/ehjacc/zuab012
Availability: https://hdl.handle.net/11562/1072189; https://doi.org/10.1093/ehjacc/zuab012
Rights: info:eu-repo/semantics/restrictedAccess ; license:Copyright dell'editore ; license uri:publisher
Accession Number: edsbas.9CD91E80
Database: BASE