Key result
Invasive microcirculation evaluation using CFR and IMR demonstrates clinical utility in acute myocardial infarction.
Systematic Review
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This review highlights the role of invasive physiologic tools, specifically CFR and IMR, in evaluating microvascular consequences like microvascular obstruction after reperfusion in acute myocardial infarction.
Acute myocardial infarction (AMI) is one of the most common causes of death in both the developed and developing world. It has high associated morbidity despite prompt institution of recommended therapy. The focus over the last few decades in ST-segment elevation AMI has been on timely reperfusion of the epicardial vessel. However, microvascular consequences after reperfusion, such as microvascular obstruction (MVO), are equally reliable predictors of outcome. The attention on the microcirculation has meant that traditional angiographic/anatomic methods are insufficient. We searched PubMed and the Cochrane database for English-language studies published between January 2000 and November 2019 that investigated the use of invasive physiologic tools in AMI. Based on these results, we provide a comprehensive review regarding the role for the invasive evaluation of the microcirculation in AMI, with specific emphasis on coronary flow reserve (CFR) and the index of microcirculatory resistance (IMR).
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Clarke et al. (2019) conducted a systematic review in Acute Myocardial Infarction. Invasive evaluation of the microcirculation (CFR and IMR) was evaluated. A comprehensive review of studies published between 2000 and 2019 highlights the role of invasive evaluation of the microcirculation, specifically CFR and IMR, in acute myocardial infarction.
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