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Cardiovascular & Hematological Agents in Medicinal Chemistry
(Formerly Current Medicinal Chemistry - Cardiovascular & Hematological Agents)
ISSN (Print): 1871-5257
ISSN (Online): 1875-6182
VOLUME: 11
ISSUE: 2
DOI: 10.2174/1871525711311020002      Price:  $58









Intracoronary Injection of Drugs to Treat No – Reflow Phenomenon and Microcirculatory Dysfunction

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Author(s): Andrea Rognoni, Alessandro Lupi, Chiara Cavallino, Gioel Gabrio Secco, Roberta Rosso and Angelo Sante Bongo
Pages 84-88 (5)
Abstract:
In a variant proportion of patients presenting with chest pain and electrocardiographic changes characteristic for ST – elevation myocardial infarction, percutaneous coronary intervention achieves epicardial coronary artery reperfusion but not the myocardial reperfusion (ranging from 5% to 50%). Furthermore, prolonged myocardial ischemia often breaks down the coronary microvasculature and the flow to the infarct myocardium may seem to be markedly reduced. This condition is known as no reflow – phenomenon. The no reflow - phenomenon is associated with an increased incidence of malignant ventricular arrhythmias, heart failure and 30-days mortality. In the recent years in literature, several articles (subsequently discussed in the present review) have been published and made relevant to the study of the pathophysiology regarding no reflow – phenomenon. This knowledge has assisted in the development of new treatment strategies, such as prophylactic use of vasodilators, mechanical devices and drugs inhibiting platelet.

The review has focused on the current literature about intra – coronary injection of drugs to treat no – reflow and microvascular dysfunction.

Keywords:
No – reflow phenomenon, microcirculatory dysfunction, acute myocardial infarction, primary coronary intervention, percutaneous coronary intervention, microcirculatory dysfunction, intracoronary drug, vascular resistance, thrombus, distal embolization.
Affiliation:
Coronary Care Unit and Catheterization Laboratory, Hospital “Maggiore della Carità”, Corso Mazzini 18, 28100 Novara, Italy.