Evidence map›Paper›PMID 40725082›Full record

ReviewInternational journal of molecular sciences2025

Molecular Mechanisms of Microvascular Obstruction and Dysfunction in Percutaneous Coronary Interventions: From Pathophysiology to Therapeutics-A Comprehensive Review.

Andre M Nicolau, Pedro G Silva, Hernan Patricio G Mejía, Juan F Granada, Grzegorz L Kaluza, Daniel Burkhoff, Thiago Abizaid, Brunna Pileggi, Antônio F D Freire, Roger R Godinho and 4 more

Abstract readReview
In one paragraph

Review in International journal of molecular sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Andre M NicolauInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0000-0003-0633-3853
Pedro G SilvaInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0009-0002-3173-3357
Hernan Patricio G MejíaInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0009-0008-0138-097X
Juan F GranadaCardiovascular Research Foundation, New York, NY 10019, USA.
Grzegorz L KaluzaCardiovascular Research Foundation, New York, NY 10019, USA.
Daniel BurkhoffCardiovascular Research Foundation, New York, NY 10019, USA.
Thiago AbizaidInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.
Brunna PileggiInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.
Antônio F D FreireInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.
Roger R GodinhoInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0009-0007-6052-2352
Carlos M CamposInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.
Fabio S de BritoInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0000-0002-6260-9626
Alexandre AbizaidInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.
Pedro H C MeloInstituto do Coração, Faculdade de Medicina, Universidade de São Paulo (InCor/HCFMUSP), São Paulo 05403-900, Brazil.ORCID 0000-0001-6928-1179

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Coronary microvascular obstruction and dysfunction (CMVO) frequently arise following primary percutaneous coronary intervention (PCI), particularly in individuals with myocardial infarction. Despite the restoration of epicardial blood flow, microvascular perfusion might still be compromised, resulting in negative clinical outcomes. CMVO is a complex condition resulting from a combination of ischemia, distal thrombotic embolization, reperfusion injury, and individual susceptibilities such as inflammation and endothelial dysfunction. The pathophysiological features of this condition include microvascular spasm, endothelial swelling, capillary plugging by leukocytes and platelets, and oxidative stress. Traditional angiographic assessments, such as Thrombolysis in Myocardial Infarction (TIMI) flow grade and myocardial blush grade, have limited sensitivity. Cardiac magnetic resonance imaging (CMR) stands as the gold standard for identifying CMVO, while the index of microvascular resistance (IMR) is a promising invasive option. Treatment approaches involve powerful antiplatelet drugs, anticoagulants, and supersaturated oxygen, yet no treatment has been definitively shown to reverse established CMVO. CMVO remains a significant therapeutic challenge in coronary artery disease management. Enhancing the comprehension of its core mechanisms is vital for the development of more effective and personalized treatment strategies.

Indexed as

Coronary Artery DiseaseMicrovesselsPercutaneous Coronary InterventionAnimalsCoronary CirculationHumansMicrocirculationMyocardial Infarctioncoronary microvascular obstructionmicrovascular dysfunctionno-reflow phenomenonreperfusion injury

Identifiers

PMID40725082
PMCPMC12295318

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.