Abstract
Distal embolization (DE) of atherothrombotic debris into the coronary microcirculation occurs both in stable and unstable coronary syndromes. Despite the well recognized clinical significance of periprocedural myocardial infarction (MI) in stable percutaneous coronary intervention (PCI), the impact of DE has a much higher prognostic impact in the acute setting, and especially in ST-elevation myocardial infarction, where DE is a main determinant of no-reflow phenomenon. The present review aims to describe the pathophysiology of DE and to summarize the currently available pharmacological strategies to prevent and treat DE in the setting of MI, especially focusing on antithrombotic, antiinflammatory and vasodilator agents.
MeSH terms
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Anti-Inflammatory Agents / therapeutic use
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Arrhythmias, Cardiac / drug therapy
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Arrhythmias, Cardiac / immunology
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Arrhythmias, Cardiac / physiopathology
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Coronary Vessels / physiopathology
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Embolism / drug therapy*
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Embolism / etiology
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Embolism / immunology
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Embolism / prevention & control*
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Humans
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Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
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Microvessels / physiopathology
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Myocardial Infarction / drug therapy*
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Myocardial Infarction / immunology
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Myocardial Infarction / physiopathology
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Platelet Aggregation Inhibitors / therapeutic use*
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Vasodilator Agents / therapeutic use*
Substances
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Anti-Inflammatory Agents
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Platelet Aggregation Inhibitors
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Vasodilator Agents