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Attractive Concept But No Evidence of Benefit

Albert Schömig, MD; Adnan Kastrati, MD

JAMA. 2005;293:1116-1118.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The goal of reperfusion therapy in acute myocardial infarction (AMI) is not only the early, full, and sustained restoration of antegrade flow at the epicardial level but also the achievement of adequate reperfusion at the myocardial level.¹ Failure to achieve myocardial reperfusion despite the presence of a patent coronary artery has been termed the "no-reflow" phenomenon and attributed to microvascular dysfunction.² Diagnostic techniques such as ST-segment resolution, angiographic blush, nuclear scintigraphy, myocardial contrast echocardiography, coronary Doppler, magnetic resonance imaging, and positron emission tomography have been used to assess the "no-reflow" phenomenon.^2-3 The presence of no reflow in patients with AMI receiving reperfusion therapies has been associated with poor outcomes.⁴

Available imaging techniques have made possible the in vivo evaluation of coronary microcirculation and, along with an increasing amount of clinical data, have provided useful information on the frequency and clinical significance of atherosclerotic microembolization.⁵ . . . [Full Text of this Article]

Author Affiliation: Deutsches Herzzentrum and 1 Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany.

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