Does late recanalization of occluded infarct-related arteries improve survival and left ventricular function in patients with myocardial infarction?
This review explores the late open-artery hypothesis, suggesting that late recanalization of occluded infarct-related arteries may improve survival through mechanisms independent of early reperfusion.
Randomized clinical trials have clearly shown that early reperfusion of coronary arteries is the established treatment of myocardial infarction preserving left ventricular function and reducing mortality. However, late patency of the infarct-related artery is an independent predictor of survival leading to the late open-artery hypothesis. This concept implies restoration of antegrade blood flow of the infarct-related artery in patients with myocardial infarction to improve survival by mechanisms less time-dependent or even time-independent. Possible explanations for this benefit include improved left ventricular function and electrical stability by perfusion of hibernating myocardium, accelerated infarct healing and limitation of ventricular remodeling. This review focuses on the evidence of late recanalization of occluded infarct-related arteries in patients with coronary artery disease.
Brueck et al. (Mon,) studied this question.
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