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Novel device-based therapies to improve outcome in ST-segment elevation myocardial infarction. [Review]

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Citation: European Heart Journal: Acute Cardiovascular Care. 10(6):687-697, 2021 Aug 24.PMID: 33760016Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Interventional Cardiology FellowshipForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Percutaneous Coronary Intervention | *ST Elevation Myocardial Infarction | Humans | Myocardial Reperfusion | Shock, Cardiogenic | ST Elevation Myocardial Infarction/su [Surgery] | Treatment OutcomeYear: 2021 ISSN:

2048-8726

Name of journal: European heart journal. Acute cardiovascular careAbstract: 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. Copyright Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2021. For permissions, please email: [email protected].All authors: Banning AP, Bhindi R, Ciofani JL, De Maria GL, Finn A, Fischell TA, Garcia-Garcia HM, Ibanez B, Kapur NK, Mathias W, Nuche J, Otterspoor L, Pijls NHJ, Ribeiro HB, Ribichini F, Sato Y, Scarsini R, Schwartz RS, Stone GW, Virmani R, Yerasi COriginally published: European Heart Journal: Acute Cardiovascular Care. 10(6):687-697, 2021 Aug 24.Fiscal year: FY2022Fiscal year of original publication: FY2022Digital Object Identifier:

https://dx.doi.org/10.1093/ehjacc/zuab012

Date added to catalog: 2021-11-01

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Title notes ( 2 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	33760016	Available		33760016

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. Copyright Published on behalf of the European Society of Cardiology. All rights reserved. (c) The Author(s) 2021. For permissions, please email: [email protected].

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