Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?
Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. I...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Radcliffe Medical Media
2020-05-01
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| Series: | Interventional Cardiology: Reviews, Research, Resources |
| Online Access: | https://www.icrjournal.com/articleindex/icr.2019.26 |
| _version_ | 1826933229806944256 |
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| author | Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning |
| author_facet | Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning |
| author_sort | Roberto Scarsini |
| collection | DOAJ |
| description | Current data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS. |
| first_indexed | 2024-03-07T17:40:32Z |
| format | Article |
| id | doaj.art-01a373ee1b404c969fd2256a01c6d234 |
| institution | Directory Open Access Journal |
| issn | 1756-1477 1756-1485 |
| language | English |
| last_indexed | 2025-02-17T17:28:45Z |
| publishDate | 2020-05-01 |
| publisher | Radcliffe Medical Media |
| record_format | Article |
| series | Interventional Cardiology: Reviews, Research, Resources |
| spelling | doaj.art-01a373ee1b404c969fd2256a01c6d2342024-12-14T16:02:08ZengRadcliffe Medical MediaInterventional Cardiology: Reviews, Research, Resources1756-14771756-14852020-05-011510.15420/icr.2019.26Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes?Roberto Scarsini0Dimitrios Terentes-Printzios1Giovanni Luigi De Maria2Flavio Ribichini3Adrian Banning4Oxford Heart Centre, NIHR Biomedical Research Centre, Oxford University Hospitals, Oxford, UK; Division of Cardiology, Department of Medicine, University of Verona, Verona, ItalyOxford Heart Centre, NIHR Biomedical Research Centre, Oxford University Hospitals, Oxford, UKOxford Heart Centre, NIHR Biomedical Research Centre, Oxford University Hospitals, Oxford, UKDivision of Cardiology, Department of Medicine, University of Verona, Verona, ItalyOxford Heart Centre, NIHR Biomedical Research Centre, Oxford University Hospitals, Oxford, UK; Division of Cardiovascular Medicine, BHF Centre of Research Excellence, University of Oxford, Oxford, UKCurrent data support the use of coronary physiology in patients with acute coronary syndrome (ACS). In patients with ST-elevation MI, the extent of myocardial damage and microvascular dysfunction create a complex conundrum to assimilate when considering clinical management and risk stratification. In this setting, the index of microcirculatory resistance emerged as an accurate tool to identify patients at risk of suboptimal myocardial reperfusion after primary percutaneous coronary intervention who may benefit from novel adjunctive therapies. In the context of non-ST-elevation ACS, coronary physiology should be carefully interpreted and often integrated with intracoronary imaging, especially in cases of ambiguous culprit lesion. Conversely, the functional assessment of bystander coronary disease is favoured by the available evidence, aiming to achieve complete revascularisation. Based on everyday clinical scenarios, the authors illustrate the available evidence and provide recommendations for the functional assessment of infarct-related artery and non-culprit lesions in patients with ACS.https://www.icrjournal.com/articleindex/icr.2019.26 |
| spellingShingle | Roberto Scarsini Dimitrios Terentes-Printzios Giovanni Luigi De Maria Flavio Ribichini Adrian Banning Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? Interventional Cardiology: Reviews, Research, Resources |
| title | Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? |
| title_full | Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? |
| title_fullStr | Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? |
| title_full_unstemmed | Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? |
| title_short | Why, When and How Should Clinicians Use Physiology in Patients with Acute Coronary Syndromes? |
| title_sort | why when and how should clinicians use physiology in patients with acute coronary syndromes |
| url | https://www.icrjournal.com/articleindex/icr.2019.26 |
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