Microcirculation as a target of myocardial reperfusion in acute coronary syndromes.

Improving the outcomes of patients with acute coronary syndromes has become a matter of great importance, since worldwide coronary artery disease is still the leading cause of morbidity and mortality. Beginning with the reperfusion era, the goal of STEMI treatment is to restore blood flow to ischemic myocardium in order to reduce infarct size, but beyond the benefit of reperfusion, an important number of patients develop reperfusion injury and the "no-reflow" phenomenon. Taking these data into account and also the fact that coronary microvascular dysfunction increases the risk of cardiovascular events, we consider that an additional strategy in order to improve the outcomes of STEMI patients could be represented by the assessment of coronary microvascular functional and structural obstruction. Along with some issues related to the pathogenesis of coronary microvascular obstruction, some diagnostic methods as well as a few therapeutic options are been presented. [ABSTRACT FROM AUTHOR]