Intracoronary pharmacotherapy in the management of coronary microvascular dysfunction

Kunadian V., Zorkun C. S., Williams S. P., Biller L. H., Palmer A. M., Ogando K. J., ...More

JOURNAL OF THROMBOSIS AND THROMBOLYSIS, vol.26, no.3, pp.234-242, 2008 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 3
  • Publication Date: 2008
  • Doi Number: 10.1007/s11239-008-0276-0
  • Journal Name: JOURNAL OF THROMBOSIS AND THROMBOLYSIS
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.234-242
  • Keywords: Microcirculation, Perfusion, Myocardial infarction, Vasoconstriction, ACUTE MYOCARDIAL-INFARCTION, NO-REFLOW PHENOMENON, OXIDE DONOR NITROPRUSSIDE, THROMBOLYTIC THERAPY, REPERFUSION INJURY, FLOW RESERVE, CONTROLLED-TRIAL, BLOOD-FLOW, ADENOSINE, INTERVENTION
  • Istanbul University Affiliated: No

Abstract

Although percutaneous coronary intervention restores optimal epicardial blood flow in most cases, abnormal myocardial perfusion may still persist. This might be as a result of macro and microembolization, neutrophil plugging, vasoconstriction, myocyte contracture, local intracellular and interstitial edema, intramural haemorrhage, and endothelial blistering. Local delivery of intracoronary pharmacotherapy via the coronary arteries may increase local drug concentration several fold, and may improve drug efficacy. Several pharmacological agents such as adenosine, calcium channel blockers, alpha blockers, beta(2) receptor activators, vasodilators, antithrombotics, and antiplatelet agents have been used to treat coronary microvascular dysfunction. This article reviews the results of trials of intracoronary pharmacotherapy to date.